EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : ABHISHEK GAJAWADA Insurance No. : 6721942215

Date of Birth : 22/02/2002 UHID : NA
Gender : Male UAN : NA
Mobile Number : 7995042828 ABHA : NA
Email ID : NA PHR Address : NA
Registration Date : 22/02/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : Anjan Kumar Gajawada

Husband
Type Of Disability : NA
Present Address : 2-2-647/77/G-10,Park view Apts,Beside Permanent Address : H.No.2-2-647/77/G-10,Park
Union Bank of India,Bagh View Apartments,Flat
Amberpet,Hyderabad,Dist:Hyderabad,Tela no-403,DD colony,Beside Union
ngana,500013 Bank of india,,Bagh
Dispensary / : Ameerpet, AP (ESIS Disp.) Dispensary / : Ameerpet, AP (ESIS Disp.)
Amberpet,Hyderabad,,Dist:Hyd
IMP for IP IMP for Family erabad,Telangana

CURRENT EMPLOYER DETAILS

Employer's Code : 67000365880000606 Name of Employer : PureSoftware Private Limited

No.

Sub Unit's Code : None Date of : 13/02/2023

No. Appointment

Address of : GREEN BLVD PLOT B9-A,3RD FLOOR Branch Office : BO - Noida-I,NOIDA-I,

Employer TOWER B SECTOR-62,NOIDA G B

FAMILY DETAILS

Name Relation Date UHID/ABHA PHR UAN/ Is Residing State/District

with of Birth Address Aadhaar with IP
IP

Telangana /
Anjan Kumar Dependant 23/02/1973 NA / NA NA NA Yes
Gajawada father
Hyderabad

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 Telangana /
Mamatha Dependant 10/06/1977 NA / NA NA NA Yes
Gajawada mother
Hyderabad

NOMINEE DETAILS

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

SAME AS
Anjan Kumar Dependant father NA NA ABOVE,TelanganaDist:Hydera 100
Gajawada bad

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) : PureSoftware Private Limited

IP Number : 6721942215
Address : 2-2-647/77/G-10,Park view Apts,Beside Union Bank of India,Bagh
Amberpet,Hyderabad,Dist:Hyderabad,Telangana,500013
Date : 22/02/2023 12:08:18PM

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