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Employees' State Insurance Corporation E-Pehchan Card: Personal Details

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safdar tanveer

This document is an e-Pehchan card that provides personal and registration details for Marcel Tilming under the Employees' State Insurance Corporation scheme. It lists his insurance number, date of birth, employer information, current address, father's name, and nominee details. The card is signed by the insured person and employer to verify the information and allow Marcel to avail cash and medical benefits under the ESI scheme.

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Employees' State Insurance Corporation E-Pehchan Card: Personal Details

Uploaded by

safdar tanveer
104 views2 pages
This document is an e-Pehchan card that provides personal and registration details for Marcel Tilming under the Employees' State Insurance Corporation scheme. It lists his insurance number, date of birth, employer information, current address, father's name, and nominee details. The card is signed by the insured person and employer to verify the information and allow Marcel to avail cash and medical benefits under the ESI scheme.

Original Title

6017313451-1

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This document is an e-Pehchan card that provides personal and registration details for Marcel Tilming under the Employees' State Insurance Corporation scheme. It lists his insurance number, date of birth, employer information, current address, father's name, and nominee details. The card is signed by the insured person and employer to verify the information and allow Marcel to avail cash and medical benefits under the ESI scheme.

Copyright:

© All Rights Reserved
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
104 views2 pages

Employees' State Insurance Corporation E-Pehchan Card: Personal Details

Uploaded by

safdar tanveer
This document is an e-Pehchan card that provides personal and registration details for Marcel Tilming under the Employees' State Insurance Corporation scheme. It lists his insurance number, date of birth, employer information, current address, father's name, and nominee details. The card is signed by the insured person and employer to verify the information and allow Marcel to avail cash and medical benefits under the ESI scheme.

Copyright:

© All Rights Reserved
Download as PDF, TXT or read online from Scribd
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You are on page 1/ 2

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : MARCEL TILMING Insurance No. : 6017313451


Date of Birth : 01/01/1996 UHID : NA
Gender : Male UAN : NA
Mobile Number : 7462016632 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 09/08/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : Nathniel Tilming


Husband
Type Of Disability : NA
Present Address : At - Chhota Gamhaira, near Vishwakarma Permanent Address : At - Torpa, Unukda,
furniture,P.O. - Bamhani,Dist:Khunti,Jharkhand
Gamhaira,Dist:Seraikela-Kharsawan,Jhark ,835216
hand,832108
Dispensary / : Saraikela Jamharia, JH (ESIS Disp.) Dispensary / : Saraikela Jamharia, JH (ESIS
IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 56001158960000606 Name of Employer : BRIGHT TECH INDUSTRIALS


No. INDIA PRIVATE LIMITED

Sub Unit's Code : 60561158960010606 Date of : 08/08/2023


No. Appointment

Address of : AC 20K, 6TH FLOOR, 11 TH Branch Office : BO - Adityapur(Pashchim


Employer PHASE,ADHARSH Singhbhum),ESI Corporation,
C/o Sh. Chittaranjan Mahto, 1st

FAMILY DETAILS

Name Relation Date UHID/ABHA Number ABHA UAN/ Is Residing State/District


with of Birth Address Aadhaar with IP
IP

Page 1 of 2
NOMINEE DETAILS

UHID/
Name of Nominee Relation with IP Date of Birth Address of Nominee Percentage(%)
ABHA Number

At - Torpa, Unukda,
Nathniel Tilming Dependant father NA NA Bamhani,JharkhandDist:Khu 100
nti835216

Affix Your Family Photograph Here. (Attested and Stamped by


Employer / ESIC Official)

Signature / LTI of Registered Employee / IP

Signature / Stamp of ESIC Officer / Employer

Note:
· This e-Pehchan card affixed with photograph of family & duly attested by the Employer/ESIC Staff shall be requested for
availing cash/medical benefit.
· e-Pehchan card is a proof of registration under ESI scheme. However eligibility for various benefits depends upon the
contribution conditions. For further information on eligibility to various Benefits, please visit- www.esic.in

Printed By (Employer/User Name) : BRIGHT TECH INDUSTRIALS INDIA PRIVATE LIMITED


IP Number : 6017313451
Address : At - Chhota Gamhaira, near Vishwakarma furniture,P.O. -
Gamhaira,Dist:Seraikela-Kharsawan,Jharkhand,832108
Date : 23/01/2024 11:54:42AM

Page 2 of 2

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