Online Application Form For Old 16Kb Card Holder

Registration No. : 0002296952

ESM Photo
Name ESM Service Number ESM Demise Date
BIRENDRA PATHAK 282093-H
ESM Gender ESM Date of Commission/Enrollment ESM Date of Retirement/Discharge ESM Type of Pension
Male 11 Jul 1965 30 Jun 2003 Service Pension
ESM Service ESM Category ESM Rank ESM Unit
Air Force JCO & Equivalent WO Warrant Officer
ESM Record Office ESM PPO No
Dte of AV III, New Delhi 08/14/B/B 441/2002

Primary Benificiaries Signature

Disability ESM Ailment %age Monthly Income
NA 0
PAN No Land Line No Marital Status Blood Group
AHMPP2967J Married AB+ve
Enter Primary benificiary Drug Allergies
Not Known
Bank Account No IFSC Code Bank/Treasury Name Bank/Treasury Address
10399370030 SBIN0009163 SBI (State Bank of India) AFS Makarpura, Baroda
Regional Centre Parent Polyclinic Station HQ
Ahmedabad Vadodara Vadodara
Primary Benificiaries Permanant Address
B42/43 Vaikunth Dham Society, Nr. Airforce Station, Makarpura, Vadodara
State District Tehsil Pin Code
Gujarat Vadodara Makarpura 390010
Primary Benificiaries Postal Address
B42/43 Vaikunth Dham Society, Nr. Airforce Station, Makarpura, Vadodara
State District Tehsil Pin Code
Gujarat Vadodara Makarpura 390010
Old Card Number
PN0022615
Dependant (Spouse):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

PRABHA DEVI PATHAK Spouse NA

Dependant Blood
Dependant Gender Dependant PAN Number Dependant Mobile No
Group
Female AB+ve DNXPP4063H 9510064937
Drug allergies
Not Known
Document Details:
Doc Desc Beneficiary Doc No
PPO Document of ESM Birendra Pathak 08/14/B/B 441/2002
Copy of Old 16KB Card Birendra Pathak PN0022615
Application Status :
Date Time Status Remarks
2023-01-23 21:23:11 Email Id Verified
2023-01-23 21:25:32 Mobile Number Verified
2023-01-23 21:57:28 Details Updated Details Saved Successfully
2023-01-23 22:47:09 Details Updated Details Saved Successfully
2023-01-23 22:47:09 Payment Initiated
2023-01-23 22:50:03 Payment Received Successfully success
2023-01-23 22:50:03 Awaiting Verification/response/document from Record Office