EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : PAVAN SUDHAKAR BHOYE Insurance No. : 3601279885

Date of Birth : 10/03/2004 UHID : NA
Gender : Male UAN : NA
Mobile Number : 7666708645 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 16/04/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : SUDHAKAR DADA BHOYE

Husband
Type Of Disability : NA
Present Address : SOMESHWAR COLONY, SATPUR, Permanent Address : SOMESHWAR COLONY,
NASHIK,Dist:Nashik,Maharashtra SATPUR,
NASHIK,Dist:Nashik,Maharasht
ra
Dispensary / : Satpur, MH (ESIS Disp.) Dispensary / : Satpur, MH (ESIS Disp.)
IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 36000351090001001 Name of Employer : BANKAR INDUSTRIAL

No. SERVICES

Sub Unit's Code : None Date of : 07/04/2023

No. Appointment

Address of : 480/29, LAXMI PLAZA,GOLE Branch Office : BO - SATPUR,Pachadeep

Employer COLONY,Dist:NashikMaharashtra422001 Bhavan,Plot No-4 Tribak Road,
Satpur, Nasik - 422007,422007

FAMILY DETAILS

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

with of Birth Address Aadhaar with IP
IP

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 NOMINEE DETAILS

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

AS
SUDHAKAR DADA Dependant father NA NA ABOVE,MaharashtraDist:Na 100
BHOYE shik

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) : BANKAR INDUSTRIAL SERVICES

IP Number : 3601279885
Address : SOMESHWAR COLONY, SATPUR, NASHIK,Dist:Nashik,Maharashtra

Date : 16/04/2023 7:10:17PM

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