EMPLOYEES' STATE INSURANCE

CORPORATION
e-Pehchan Card

PERSONAL DETAILS

Name of IP : DEBASIS DEY Insurance No. : 4111349126

Date of Birth : 19/08/1973 UHID : WB01.0001352743

Gender : Male UAN : 100007850680

Mobile Number : 9038512634 ABHA Number : 91-3343-6858-8888

Email ID : NA ABHA Address : 91334368588888@abdm

Registration Date : 01/06/2010 Aadhaar : Verified

REGISTRATION DETAILS

Marital Status : Married Name of Father / : LATE BIBHUTI DEY

Husband
Type Of Disability : NA

Present Address : 43/7 A C BANERJEE Permanent Address : 43/7 A C BANERJEE

RD,ARIADAHA,KOLKATA,Dist:North 24 RD,ARIADAHA,KOLKATA,Dist:
Pargana,West Bengal,700057 North 24 Pargana,West
Bengal,700057
Dispensary / : Kamarhati, WB (ESIS Disp.) Dispensary / : Kamarhati, WB (ESIS Disp.)
IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 56001007240001002 Name of Employer : J.G.HOSIERY PVT LTD.

No.

Sub Unit's Code : 41561007240031002 Date of : 01/02/2020

No. Appointment

Address of : 28, B.T.Road,Cossipore, Lohia Branch Office : BO - COSSIPORE,46/1- G,

Employer press,Dist:KolkataWest Bengal700002 B.T. ROAD, KOLKATA Â? 700
002,0 NA

FAMILY DETAILS

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

with of Birth Address Aadhaar
with IP
IP

West Bengal /
TUMPA DEY Spouse 27/07/1980 NA/75-5352-7412-3 755352 Verified Yes
BASAK 772 741237
North 24 Pargana
72@ab
dm

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 West Bengal /
SARANYA DEY Minor 17/02/2013 Verified Yes
dependant son
North 24 Pargana

NOMINEE DETAILS

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

43/7 A C BANERJEE RD
TUMPA DEY Spouse NA NA ARIADAHA KOL-57,West 100
BASAK BengalDist:North 24
Pargana700057

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) : J.G.HOSIERY PVT LTD.

: 4111349126
IP Number
Address : 43/7 A C BANERJEE RD,ARIADAHA,KOLKATA,Dist:North 24 Pargana,West
Bengal,700057
Date: 19/01/2024 2:42:17PM

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