Page 1 - Sujoy_Das (1)_Neat

EMPLOYEES' STATE INSURANCE CORPORATION
e-Pehchan Card

Insured Person : Sujoy Das
Insurance No. : 5210923522
Date of Registration : 08/11/2014

YOUR REGISTRATION DETAILS
Employee Name: Sujoy Das Type of Disability : None
Name of Father / Husband: Sudarshan Das Date of Birth : 02/07/1988

Marital Status : Married Gender : Male
Vill+P.O- Jagatnagar, P.S- Vill+P.O- Jagatnagar, P.S-
Present Address : Permanent Address :
Singur,Dist:Hoogly,West Bengal,712409 Singur,Dist:Hoogly,West Bengal,712409

Dispensary / IMP for IP : None Dispensary / IMP for Family: None
UHID
Current Employer Details First Employer Details

Employer's Code No. : 15000645900000911 Employer's Code No. : None

Sub Unit's Code No. : None Sub Unit's Code No. : None
Date of Appointment : 10/08/2020 First Insurance No. : None
Name of Employer : skymap global (India) pvt. ltd. Name of Employer : None
5/65, SFS, KABIR AVENUE,
Address of Employer : Address of Employer : None
MANSAROVAR-JAIPUR,Dist:JaipurRajastha
n302020

Family Details:
Name Relationship Date of Birth UHID Whether Residing State District
with the with Insured Person
Employee

Sudarshan Das Dependant father 26/03/1958 Yes West Bengal Hoogly

Anita Das Dependant mother 01/01/1970 Yes West Bengal Hoogly

Atasi Nandy Das Spouse 01/01/1989 Yes West Bengal Hoogly

Adrija Das Dependant 28/07/2017 Yes West Bengal Hoogly
unmarried daughter

Nominee Details:
Name of Nominee Relationship with IP Percentage Address of Nominee
Atasi Nandy Das Spouse Vill+P.O- Jagatnagar, P.S- Singur, Dist-
100
Hooghly,West
BengalDist:Hoogly712409