Online Application Form For Death Cases when in Service

Registration No. : 0002453415

Name ESM Service Number ESM Demise Date
SARVAN KUMAR OJHA $$$-16116469-X 31 Mar 2016
ESM Date of ESM Date of
ESM Gender ESM Type of Pension
Commission/Enrollment Retirement/Discharge
Male 06 Mar 2009 01 Jan 1900 Special Family Pension
ESM Service ESM Category ESM Rank ESM Unit
HAKIMPET
Army OR & Equivalent Nk
SECUNDRABAD
ESM Record Office ESM PPO No
Madras Engr Gp, Bangalore F/20011/2017
Family Pensioners Photo

Family Pensioners Name Relation with ESM

DIMPLE Spouse

Primary Benificiaries Signature

Disability ESM Ailment %age Monthly Income
NA 0
PAN No Land Line No Marital Status Blood Group
Widow B+ve
Enter Primary benificiary Drug Allergies
Not Known
Bank Account No IFSC Code Bank/Treasury Name Bank/Treasury Address
520101051674595 UBIN0916048 UNION BANK JAITPUR BRANCH, SOUTH EAST DELHI-110044
Regional Centre Parent Polyclinic Station HQ
Bangalore MEG Centre Bangalore Bangalore
Primary Benificiaries Permanant Address
D-2/64 GALI NO-2 HARI NAGAR EXTN JAITPUR BADARPUR NEW DELHI
State District Tehsil Pin Code
Delhi South East Delhi SARITA VIHAR 110044
Primary Benificiaries Postal Address
D-2/64 GALI NO-2 HARI NAGAR EXTN JAITPUR BADARPUR NEW DELHI
State District Tehsil Pin Code
Delhi South East Delhi SARITA VIHAR 110044
Dependant (Father):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

THEKEDAR OJHA Father NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Male B+ve Not Available 9958095266
Drug allergies
Not Known
Dependant (Mother):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

NIRMALA DEVI Mother NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Female B+ve Not Available 9958095266
Drug allergies
Not Known
Dependant (Son):
Dependent Photo Dependant Name Relation Disability Details Dependent Sign

ANURAG OJHA Son NA

Dependant Gender Dependant Blood Group Dependant PAN Number Dependant Mobile No
Male B+ve Not Available 9958095266
Drug allergies
Not Known
Document Details:
Doc Desc Beneficiary Doc No
Death Certificate of ESM DIMPLE 77/TY/2016
Application Status :
Date Time Status Remarks
2023-11-23 12:26:55 Email Id Verified
2023-11-23 12:27:53 Mobile Number Verified
2023-11-23 13:54:49 Details Updated Details Saved Successfully
2023-11-23 13:54:49 Payment Initiated
2023-11-23 13:57:42 Payment Received Successfully success
2023-11-23 13:57:42 Awaiting Verification/response/document from Record Office