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User Wednesday, December 13, 2023

Login: 24000882220000199 5:16:35 PM

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

Insured Person : JATINDER KUMAR

Insurance No. : 2414068219
Date of Registration : 03/06/2010
YOUR REGISTRATION DETAILS
Please seed Universal Account Number (UAN)
Employee Name: JATINDER KUMAR Type of Disability: NA
Name of Father /
SHR. LACHMAN DASS Date of Birth: 12/03/1983
Husband:
Marital Status: Married Gender: Male
H.NO. 1544-A,VIJAY NAGAR,AMBALA H.NO. 1544-A,VIJAY NAGAR,AMBALA
Present Address: CITY,HARYANA,Dist:Ambala,Haryana,134003
Permanent Address: CITY,HARYANA,Dist:Ambala,Haryana,134003
Dispensary / IMP for Old Civil Hosp. Bldg, Ambala, HR (ESIS Dispensary / IMP for Old Civil Hosp. Bldg, Ambala, HR (ESIS
IP: Disp.) Family: Disp.)
UHID: HR01.0000878903 ABHA Number: NA
UAN: NA EmailID: NA
ABHA Address: NA Aadhaar: NA
Employer's Code
Employer's Code No.: 24000882220000199 None
No.:
Sub Unit's Code No.: None Sub Unit's Code No.: None
Date of Appointment: 19/01/2023 First Insurance No.: None
RAJAN WHOLESALE BAZAAR PRIVATE
Name of Employer: LIMITED
Name of Employer: None

NH-01,Kalka Chowk, Vita Enclave,Ambala Address of

Address of Employer: City,Ambala,Dist:AmbalaHaryana134003
None
Employer:

Family Details

Relationship Whether
UHID/ABHA ABHA Place of
Name with the Date of Birth UAN/Aadhaar Residing with
Number Address Residence
Employee IP
State District
SMT. AARTI Spouse 25/09/1983 HR01.0000593744/NA
NA NA No Haryana Ambala
KANTA RANI Dependant 01/07/1950 HR01.0000593742/NA
NA NA No Haryana Ambala
mother
SHR.
LACHMAN Dependant father 05/03/1950 HR01.0000593743/NA
NA NA No Haryana Ambala
DASS
NISHCHAY Minor dependant
23/06/2021 HR01.0007302609/NA
NA NA Yes Haryana Ambala
KUMAR son
Nominee Details
Percentage
Name of Nominee Relationship with IP Date of Birth UHID/ABHA Number Address of Nominee
Allotted
H.NO. 1544-A,VIJAY
SMT. AARTI Spouse NA NA NAGAR,AMBALA 100
CITY,HaryanaDist:Ambala00000
Documents none
Uploaded:

BO - Ambala,7-8-9, Palika Bazar,Mahesh Nagar,Ambala Cantt. Pin Code:133001,134003

Affix Your Family Photograph Here.(Attested and Stamped by Employer /
ESIC Official)
Signature / LTI of
Registered
Employee / IP :

Mobile No. :
8307475749

NOTE:

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