EMPLOYEES STATE INSURANCE CORPORATION YOUR REGISTRATION DETAILS First Name *Last Name *Insurance NoName of Father/Husband *Marital Status *MarriedUnmarriedDate of Birth *Permanent Address *Current Address *Nominee DetailsFamily Details and Date of Birth (DOB) with full Address *Nominee Address *Name of Nominee *Relationship with Employee *Family group photo who take benefit of ESIC *Choose FileNo file chosenDelete uploaded filePassbook Scan copy or Cancel Cheque *Choose FileNo file chosenDelete uploaded fileAttached All Member Adhar Card *Drag and Drop (or) Choose FilesApply Now
