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Abhishek Esic

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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : ABHISHEK CHAWDA Insurance No. : 1816235979


Date of Birth : 11/09/2000 UHID : NA
Gender : Male UAN : 101680180463
Mobile Number : 8305467110 ABHA : NA
Email ID : NA PHR Address : NA
Registration Date : 26/02/2020 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : Rahul Chawda


Husband
Type Of Disability : NA
Present Address : Sagore Kuti,Pithampur,Dist:Dhar,Madhya Permanent Address : Sagore
Pradesh Kuti,Pithampur,Dist:Dhar,Madhy
a Pradesh

Dispensary / : Pithampur 3-4, MP (ESIS Disp.) Dispensary /


: Pithampur 3-4, MP (ESIS Disp.)
IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 36000005340001019 Name of Employer : Industrial Labour Associates


No.

Sub Unit's Code : 18360005340011019 Date of : 26/02/2020


No. Appointment

Address of : C/O MYLAN LABORATORIES Branch Office : BO - Pithampur 3-4,ESIC Branch


Employer LTD,PITHAMPUR SEZ APPAREL Office, Verma Bhawan Nehar
PARK,Dist:DharMadhya Pradesh450001 Mahajan Sweet Sagore Kuti
Square
,Pithampur,Dhar-454774,0
FAMILY DETAILS

Relation
Date UAN/
Name with UHID/ABHA PHR Address State/District
of Birth Aadhaar
IP

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NOMINEE DETAILS

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

Sagore
Rahul Chawda Dependant father NA NA Kuti,Pithampur,Madhya 100
PradeshDist:Dhar

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) : Industrial Labour Associates


IP Number : 1816235979
Address : Sagore Kuti,Pithampur,Dist:Dhar,Madhya Pradesh

Date : 08/11/2022 10:55:52AM

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