EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : USHA ANANTA GUND Insurance No. : 3415062165

Date of Birth : 01/01/1976 UHID : NA
Gender : Female UAN : NA
Mobile Number : NA ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 22/07/2019 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : ANANTA GUND

Husband
Type Of Disability : NA
Present Address : 466, VITTALGAON (N. V.), THANE, Permanent Address : 466, VITTALGAON (N. V.),
ALYANI,,MAHARASHTRA THANE,
421601,Dist:Thane,Maharashtra ALYANI,,MAHARASHTRA
421601,Dist:Thane,Maharashtra
Dispensary / : Thane(W), MH (ESIS Disp.) Dispensary / : Thane(W), MH (ESIS Disp.)
IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 34000359160001099 Name of Employer : RIDDHI ENTERPRISES

No.

Sub Unit's Code : None Date of : 01/04/2019

No. Appointment

Address of : 420, LAXMAN NAGAR, GOTHEGHAR, Branch Office : BO - Thane,Panchdeep

Employer KHUTEGHAR, SHAHAPUR, Bhavan, Ground Floor, Plot No.
A-12/1, MIDC, Next to Wagle

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

466, VITTALGAON (N. V.),

ANANTA GUND Spouse NA NA THANE, 100
ALYANI,MAHARASHTRA
421601,MaharashtraDist:Tha
ne

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) : RIDDHI ENTERPRISES

IP Number : 3415062165
Address : 466, VITTALGAON (N. V.), THANE, ALYANI,,MAHARASHTRA
421601,Dist:Thane,Maharashtra
Date : 26/07/2023 11:42:57AM

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