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    5221549783

    Uploaded by

    Ambati Madhava Reddy

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    5221549783

    Uploaded by

    Ambati Madhava Reddy
    0 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    0 views2 pages

    5221549783

    Uploaded by

    Ambati Madhava Reddy

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    EMPLOYEES' STATE INSURANCE CORPORATION

    e-Pehchan Card

    PERSONAL DETAILS

    Name of IP : MATANGI SANDHYARANI Insurance No. : 5221549783


    Date of Birth : 01/01/1999 UHID : NA
    Gender : Female UAN : NA
    Mobile Number : 9515471375 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 05/12/2024 Aadhaar : NA

    REGISTRATION DETAILS

    Marital Status : Married Name of Father / : Sandeep Balusupalli


    Husband
    Type Of Disability : NA
    Present Address : Block No 22,Flat No 24 Jnnurm Permanent Address : Block No 22,Flat No 24 Jnnurm
    Colony,,Cherlapally Colony,,Cherlapally
    Village,Ghatkesar,Dist:Medchal,Telangana Village,Ghatkesar,Dist:Medchal
    ,501031 ,Telangana,501031
    Dispensary / : IDA CHERLAPALLY Dispensary / : IDA CHERLAPALLY
    IMP for IP IMP for Family

    CURRENT EMPLOYER DETAILS

    Employer's Code : 52002288920000907 Name of Employer : SAA VEE ENTERPRISES


    No.

    Sub Unit's Code : None Date of : 26/11/2024


    No. Appointment

    Address of : 136, 137,V R Branch Office : BO -


    Employer Colony,Cherlapally,Dist:RangareddyTelan Jeedimetla(Rangareddy),Beside
    HMT overhead Tank,

    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

    Block No 22,Flat
    Balusupalli Sandeep Spouse NA NA No24,Jnnurm 100
    Colony,TelanganaDist:Medch
    al501301

    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) : SAA VEE ENTERPRISES


    IP Number : 5221549783
    Address : Block No 22,Flat No 24 Jnnurm Colony,,Cherlapally
    Village,Ghatkesar,Dist:Medchal,Telangana,501031
    Date : 05/12/2024 10:41:41AM

    Page 2 of 2

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