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e-Pehchan Card Registration Details

The document is an e-Pehchan card for Rufus Praveen E, an employee of Wow Momo Foods Pvt Ltd, containing personal and registration details such as his insurance number, date of birth, and address. It also includes information about his family, specifically his father A.L Edwin as his nominee. The card serves as proof of registration under the ESI scheme and is required for availing cash and medical benefits.

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praveenrufus942
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72 views2 pages

e-Pehchan Card Registration Details

The document is an e-Pehchan card for Rufus Praveen E, an employee of Wow Momo Foods Pvt Ltd, containing personal and registration details such as his insurance number, date of birth, and address. It also includes information about his family, specifically his father A.L Edwin as his nominee. The card serves as proof of registration under the ESI scheme and is required for availing cash and medical benefits.

Uploaded by

praveenrufus942
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : RUFUS PRAVEEN E Insurance No. : 5136775114


Date of Birth : 12/02/1999 UHID : NA
Gender : Male UAN : NA
Mobile Number : 9087328698 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 16/11/2024 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : A.L Edwin


Husband
Type Of Disability : NA
Present Address : No.28, 6th,Main Road Banu Nagar,Pudur, Permanent Address : No.28, 6th,Main Road Banu
Ambattur,Dist:Chennai,Tamilnadu,600053 Nagar,Pudur,
Ambattur,Dist:Chennai,Tamilna
du,600053
Dispensary / : Anna Salai Chetpet, TN (ESIS Disp.) Dispensary / : Anna Salai Chetpet, TN (ESIS
IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 41000522200000011 Name of Employer : Wow Momo Foods Pvt Ltd
No.

Sub Unit's Code : 51410522200010011 Date of : 08/11/2024


No. Appointment

Address of : 324 Reshma apartment,M K N Branch Office : BO - Guindy,ESI Corporation,


Employer Road,Alandur,Dist:ChennaiTamilnadu600 No.17/A Muthaiyal Street (2nd
Floor), Opp. to

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Page 1 of 2
NOMINEE DETAILS

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

SAME,TamilnaduDist:Chenn
A.L Edwin Dependant father NA NA ai600053 100

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- [Link]

Printed By (Employer/User Name) : Wow Momo Foods Pvt Ltd


IP Number : 5136775114
Address : No.28, 6th,Main Road Banu Nagar,Pudur,
Ambattur,Dist:Chennai,Tamilnadu,600053
Date : 16/11/2024 [Link]PM

Page 2 of 2

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