Online Application Form For Future Retiree

Registration No. : 0001559383

ESM Photo
Name ESM Service Number ESM Demise Date
SRINIVAS A JC-303622-L
ESM Gender ESM Date of Commission/Enrollment ESM Date of Retirement/Discharge ESM Type of Pension
Male 09 Mar 2000 30 Sep 2020 Service Pension
ESM Service ESM Category ESM Rank ESM Unit
Army JCO & Equivalent Sub Army AD Centre (ATR)
ESM Record Office ESM PPO No
Army Air Def Records, Gopalpur 173202002029

Primary Benificiaries Signature

Disability ESM Ailment %age Monthly Income
NA 0 0
PAN No Land Line No Marital Status Blood Group
AHRPA0504B Married O+ve
Enter Primary benificiary Drug Allergies
Not Known
Bank Account No IFSC Code Bank/Treasury Name Bank/Treasury Address
H. No. 6-6-79, Ground Floor of Town Club, Sircilla,
30051141132 SBIN0012903 State Bank of India, Sircilla
Dist : Rajanna Sircilla, State : Telangana, PIN : 505301
Regional Centre Parent Polyclinic Station HQ
Hyderabad Golconda Secunderabad
Primary Benificiaries Permanant Address
H. No. 9-2-70, Nehrunagar, Sircilla, State : Telangan
State District Tehsil Pin Code
Telangana Rajanna Sircilla Sircilla 505301
Primary Benificiaries Postal Address
H. No. 9-2-70, Nehrunagar, Sircilla, State : Telangan
State District Tehsil Pin Code
Telangana Rajanna Sircilla Sircilla 505301
Dependant (Spouse):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

LINDAM MADHAVI Spouse NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Female O+ve Not Available 8074590570
Drug allergies
Not Known
Dependant (Son):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign
 ANNAL DAS ADITH Son NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Male O+ve Not Available 9671013290
Drug allergies
Not Known
Dependant (Son):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

ANNALDAS NIHAL Son NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Male O+ve Not Available 9671013290
Drug allergies
Not Known
Dependant (Mother):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

A KALAVATHI Mother NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Female O+ve Not Available 8099105399
Drug allergies
Not Known
Application Status :
Date Time Status Remarks
2020-06-24 11:27:11 Email Id Verified
2020-06-24 11:28:41 Mobile Number Verified
2020-08-06 22:09:36 Details Updated Details Saved Successfully
2020-08-06 22:09:36 Payment Initiated
2020-08-06 22:21:19 Payment Received Successfully Completed Successfully
Awaiting Verification/response/document from Record
2020-08-06 22:21:19
Office
2020-09-14 22:16:53 Details Updated Details Saved Successfully
2020-09-24 12:09:16 Details Updated Details Saved Successfully
2020-10-03 09:20:09 Verification Complete
Card Printed For Beneficiary (SRINIVAS
2020-12-31 23:08:18 Card Printed
A)
Card Printed For Beneficiary (LINDAM
2020-12-31 23:10:37 Card Printed
MADHAVI)
Card Printed For Beneficiary (ANNAL
2020-12-31 23:11:12 Card Printed
DAS ADITH)
Card Printed For Beneficiary (ANNALDAS
2020-12-31 23:11:45 Card Printed
NIHAL)
Card Printed For Beneficiary (A
2020-12-31 23:12:18 Card Printed
KALAVATHI)
Card Ready For Dispatch For Beneficiary
2021-01-01 13:27:16 Card Tested & Ready For Dispatch From Source
(SRINIVAS A)
Card Ready For Dispatch For Beneficiary
2021-01-01 13:27:16 Card Tested & Ready For Dispatch From Source
(LINDAM MADHAVI)
Card Ready For Dispatch For Beneficiary
2021-01-01 13:27:16 Card Tested & Ready For Dispatch From Source
(ANNAL DAS ADITH)
Card Ready For Dispatch For Beneficiary
2021-01-01 13:27:16 Card Tested & Ready For Dispatch From Source
(ANNALDAS NIHAL)
Card Ready For Dispatch For Beneficiary
2021-01-01 13:27:16 Card Tested & Ready For Dispatch From Source
(A KALAVATHI)
 Card Dispatch For Beneficiary (SRINIVAS
2021-01-06 00:00:00 Card Dispatched From Source
A)
Card Dispatch For Beneficiary (LINDAM
2021-01-06 00:00:00 Card Dispatched From Source
MADHAVI)
Card Dispatch For Beneficiary (ANNAL
2021-01-06 00:00:00 Card Dispatched From Source
DAS ADITH)
Card Dispatch For Beneficiary
2021-01-06 00:00:00 Card Dispatched From Source
(ANNALDAS NIHAL)
Card Dispatch For Beneficiary (A
2021-01-06 00:00:00 Card Dispatched From Source
KALAVATHI)
Card Received by Regional Centre
2021-01-14 10:17:20 Card Received By Regional Centre
(SRINIVAS A)
Card Received by Regional Centre
2021-01-14 10:17:20 Card Received By Regional Centre
(LINDAM MADHAVI)
Card Received by Regional Centre
2021-01-14 10:17:20 Card Received By Regional Centre
(ANNAL DAS ADITH)
Card Received by Regional Centre
2021-01-14 10:17:20 Card Received By Regional Centre
(ANNALDAS NIHAL)
Card Received by Regional Centre (A
2021-01-14 10:17:20 Card Received By Regional Centre
KALAVATHI)
Card Dispatched to Station Headquarter
2021-01-14 10:20:25 Card Dispatched to Station Headqarter
(SRINIVAS A)
Card Dispatched to Station Headquarter
2021-01-14 10:20:25 Card Dispatched to Station Headqarter
(LINDAM MADHAVI)
Card Dispatched to Station Headquarter
2021-01-14 10:20:25 Card Dispatched to Station Headqarter
(ANNAL DAS ADITH)
Card Dispatched to Station Headquarter
2021-01-14 10:20:25 Card Dispatched to Station Headqarter
(ANNALDAS NIHAL)
Card Dispatched to Station Headquarter (A
2021-01-14 10:20:25 Card Dispatched to Station Headqarter
KALAVATHI)
Card Received at Stn HQ (Report to Stn HQ only after Card Received by Station Headquarter
2021-03-15 18:05:13
receiving SMS for collection with OTP and documents). (SRINIVAS A)
Card Received at Stn HQ (Report to Stn HQ only after Card Received by Station Headquarter
2021-03-15 18:05:16
receiving SMS for collection with OTP and documents). (LINDAM MADHAVI)
Card Received at Stn HQ (Report to Stn HQ only after Card Received by Station Headquarter
2021-03-15 18:05:19
receiving SMS for collection with OTP and documents). (ANNAL DAS ADITH)
Card Received at Stn HQ (Report to Stn HQ only after Card Received by Station Headquarter
2021-03-15 18:05:21
receiving SMS for collection with OTP and documents). (ANNALDAS NIHAL)
Card Received at Stn HQ (Report to Stn HQ only after Card Received by Station Headquarter (A
2021-03-15 18:05:23
receiving SMS for collection with OTP and documents). KALAVATHI)
Verified & SMS OTP Processed at Stn HQ
2021-03-16 14:12:20 SMS OTP Processed by Stn HQ
(SRINIVAS A)
Verified & SMS OTP Processed at Stn HQ
2021-03-16 14:12:20 SMS OTP Processed by Stn HQ
(LINDAM MADHAVI)
Verified & SMS OTP Processed at Stn HQ
2021-03-16 14:12:20 SMS OTP Processed by Stn HQ
(ANNAL DAS ADITH)
Verified & SMS OTP Processed at Stn HQ
2021-03-16 14:12:20 SMS OTP Processed by Stn HQ
(ANNALDAS NIHAL)
Verified & SMS OTP Processed at Stn HQ
2021-03-16 14:12:20 SMS OTP Processed by Stn HQ
(A KALAVATHI)
2021-03-28 01:58:07 SMS OTP Sent & Card is Ready For Collection Card Ready For Collection (SRINIVAS A)
Card Ready For Collection (LINDAM
2021-03-28 01:58:07 SMS OTP Sent & Card is Ready For Collection
MADHAVI)
Card Ready For Collection (ANNAL DAS
2021-03-28 01:58:07 SMS OTP Sent & Card is Ready For Collection
ADITH)
Card Ready For Collection (ANNALDAS
2021-03-28 01:58:07 SMS OTP Sent & Card is Ready For Collection
NIHAL)
Card Ready For Collection (A
2021-03-28 01:58:07 SMS OTP Sent & Card is Ready For Collection
KALAVATHI)
Card Handed Over To Beneficiary
2021-07-16 10:46:02 Card Handedover to Individual
(LINDAM MADHAVI)
 Card Handed Over To Beneficiary
2021-07-16 10:46:30 Card Handedover to Individual
(ANNAL DAS ADITH)
Card Handed Over To Beneficiary (A
2021-07-16 10:47:07 Card Handedover to Individual
KALAVATHI)
Card Handed Over To Beneficiary
2021-07-16 10:47:29 Card Handedover to Individual
(ANNALDAS NIHAL)
Card Handed Over To Beneficiary
2021-07-16 10:47:56 Card Handedover to Individual
(SRINIVAS A)
2021-07-16 10:57:26 Change of polyclinic request is initiated by individual Resettled in Golconda (5968870 )
2021-07-16 10:59:01 Change of polyclinic request is initiated by individual Resettled in Golconda (6028852 )
2021-07-16 11:00:07 Change of polyclinic request is initiated by individual Resettled in Golconda (6028854 )
2021-07-16 11:00:55 Change of polyclinic request is initiated by individual Resettled in Golconda (6028855 )
2021-07-16 11:01:53 Change of polyclinic request is initiated by individual Resettled in Golconda (6028857 )
2021-10-18 15:57:14 Change of polyclinic request is initiated by individual Resettlement at Golconda (6028857 )