EMPLOYEES' STATE INSURANCE CORPORATION

' . €'Pehchan Card

lnsur€d PaEon Sudhlr Bhlmarao Krthlne

t'o' :

}' ksurarics l',1o. ; 2303tO7?35

.. o7$7no21
P:F4}"it"u"u*

Sudhir Bhlmerao Kathan6 TYps of Oisabllity

l{ame ot Fathor / Husband EHIMARAO Dat€ of Binh : 07/c1/1991

Gencler Ma16
Marital Status : Manied i

RAJIV NA6AR BORIBK RAJIV NAGAR BORI BK

Permansnt Address
YAVATMAL,DIst:Ya!-atrnal,Maharashtra YAVATMAL Olst Yavafi 6l,Mahara8htra

Dllpenlary / IMP for lP : Amravati, MH (ESIS Dlsp.) Dlsperuary / IUP fot Famlly: AmrsvsU, MH (ESIS DisP.)

UHIO MHO1 .0011792622

cur..nt Employ6r Dcllllt Flr.l E nFloyer Octalb

Ehploy6/. Cod.l{o, : 330005233300001 9S Ernploy./s Cod. I{o. l Non6

sub Unlfs cods No. i 2333052s330010199 Sub Unlt'i Code l{o. : Non6

Drtc ot Appolntm€nt : 2A10612021 Flrst lnsutanca l{o.: None

rm. of Ehploy.t PRATAP INDUSTRIES LfD N.m! of Employor Non€

Plot No. T-33, Nandgaon Peth,

Addrar. ot E.nploy.r i Addr.., ol Emplot t:
Mloc,Addittonsl lndustrlal

44901

Family Details:
RElatlon-shlp Dato ol Blrth Hto Wh.th.r Rcildlng Slars Dlstrlct
wlth th. with lntuEd P.6on
Enployo.

r
PRAMILA Dep€ndenl moth€r 01/05i 1970 01.0011792623 1\raharashtra Yavatmel
BHIMARAO
--r*Tt#fi-f
BHIMRAO 01i08/1967 41.0011792624

r
Dependant father Yes l\rehaBsht a Yavalmal
RAMRAOJ I

PRATIKSHA Spous€ 01/01/19S2 01.00117926/t8 Yes I\rah6rashtra Yavalmal

SUDHIR
l,'
Nomlnee Details:
Rahtlonlhlp wlth lP Percentage Addrr$ ol ltomln€s
PRATIKSHA SUOHIR XATHANE Spouss RAJIV NAGAR BORI BK
100
YAVATMAL, MahararhtraDisf Yavaunal
M/s. Aarogyam lnstitule
ofledicatfsens
I
r
eef
l: Kanrla H. Mrrkg,
*o.,.ro.r,k?loh''
Documsnts Uploaded:

Signalur€ / LTI ofRegistsrEd Employoe / lP :

!Elr
'-f

I ! 'l N.
,
I
l\,lobile Number : 9561271252

NOTE:

1 . Ploesa k€6p this pdntout for future roIer6nc6 and bring thls along with your Photo lO for all your Claim BeneliE
and Medlcal Eenefb
2. Employor to pleaso afllx omployoB and hls famlly photo h6re and anost wlth oficial stamp across .

Slgnature / Sbmp of ESIC Oficer / Employer \

 711212?,'12:31 PM ESIC lP lnlerface

C Empioyee Oeqaib
dmbtoyees' Coiporaiion

Login lJser manprap

titlement to Benefits
Lan g u age/qTIII
I Englistr v
I Jlnsurance Percon Number 2303807736 llnsuIance peBon Name rsiiiixii ei'MilF Ao KAiiiNi

i]""r", Cunent Period iRepo,t Generated on Dated i1210712022 12.31i08 Ht

rBenelit Period Eligiblity

lBenefit Stalt Date Benefit End Date TotalWag6s ltot"tWort trg Oays Paid / Payable
Contributioh I Contrlbution
Period From
-.1__-__.__ ::-. _"1 .: , :, ,,1it11,1l.1,
01 Jeft 2022 l30 Jun 2022 8?991.-00 r,o! 0l Y:2Yl 30 Sep 2021
;Oi Jrlz0z? ]31 Dec 2022 132059.O0 t9l :, Ocl2O2l
-
|iru". r"zi - -

Eligiblity to ESIC Behefits

: Behofit Type Entitlement Statl]s lProbable Reasons for Non-Entitlement to Benefits ln case entitle ment
iatatus Is No
,rl# Medical Benefit ;lP/lW not in insurable employment and contilbutory conditions are not rnet
il1!h!_c9!rl:p91qi!9c9!-!4-b-!!19!-P,{.99_
i'Not an M.
Matemity Benofit No l' Lo.a than 9 months ol insurablo .hploymont on EDD / Date of d6liv6ry,
l' L€ss than 70 days contrlbution in 2 prcc.dlng Contribution P.riod.
l'Lesa than I monlhs o, lnslrrable employmenl ftom th6 drte of rirst
:apt ointmont
Sickness Behefit l'Contibutod less then 78 dey! in th6 corr€lpondlng contributjon p€rlod
:'lf €ntered in lnsurablo employment tor tho frst ms in any Contribu0on
p€rlod and contributed for lssr than half no. ofday6 of such shonor
rContrlbutlon perlod.

i'Not 9ufi€rihg ftom ahy of tho listed 34 disease3.

'Less than two years continuous insulable employment.
' Extended Sickness Benefit Yes ''Contaibuted for less thah 156 days ln pfoceeding four Cohtribution
lperioda (Two year3).
tlol entltled tor SB h any one of tho four precedl n9 Cohtribuiion Periods
inrt"n."a !Lrn".. a.n"nt E-
l
Not Entitled tor Sickness Benefit

l"
l---
i' Not completed slx months of seNlco from Data of reglstratloh
Cohtdbuted less than 78 days in a contribution period.
''Nol completed ysar
I Cohtrlbuted- les!onethan 78ofday8
servlc€ from date ol registraton
#Super Specialty For Family
i:._ *=;o-l"Ju"i-ii-"J tn each of tE
ryo lqlq!-bgiojr p_:I.d:-.,. .J
a,i" t" i.ptvr"iiir"rury or occuparionat Dtsease a! per
,
:
lt*n"1"w 1*"ol_"-ent-Benefi : Ithe ESI Act.
' Permanent Disablment Benefit 'Yes iDisablement not due to Employment lnjury oa Occupatlonal Olsease as per
ithe ESI Act-
Dependent B€nefit Yes Doath ofthe lnsurod porson is not due to Employmort lnjury o.
Occupational Dlsease as per the ESI Act.
:'Not an lPl Iw on the data of los3 of lnsurable Employment on account of
retfenchment under lD act, closure ot the factory , establllhment undar lD
, R.G.S.K.Y No ,act or pemanent lnvalldlty of not less than iO% arislng out of non_
.employmsht inlury,
!' Less than three years (Ono year = 'l56 days) contribudon pald,/payable
jpaior to loss ofemployment.
'Ward of lP' certlficate as on 31.10.2018 :y6s '*
IF
-:':Jlf-:llt_tl.ry :!]usis ra"ua onry on rne J"t" oi onrrn"
r ho rrst rs not exhaustivo.
i"qi;fii."
i. *,. iv"t .. -
- -'
For further detairs preass visit near;st Branch ofrico or www.esic.nic.in.
todey's date and is Iurther subject to t edical Certificates and/oiotfr"i E ligibility status shown here is as on
it r'f, The errgrb,rty shown here based on rhe crrcura. humber v-14li orzoiimea.i'tr,tts"
""naitioi=.
- -- ' aated 11.03.2021
ll # Ellgibility shall be subiect to docisjon/discretiorrot the treaflng
"flri"i"n.
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