Yes. Form 105 is the monthly contribution return. However, now it is replaced by an online electronic return on the portal.
Whether you are traveling for or temporary duty , this form ensures you and your family can receive treatment at any ESI dispensary or hospital across India. Purpose of ESIC Form 105
In the old manual system, Form 105 accompanied the monthly challan. Today, the digital uses an electronic version, but many HR professionals prefer the Word version to maintain soft copies or prepare bulk data. esic form 105 word format
Copy the table structure from this article into Microsoft Word, adjust column widths, and you are ready to go.
However, in the context of current ESIC workflows, Form 105 is most frequently utilized as a . It acts as a voucher or an authorization document that validates the period of sickness or treatment. Whether you are traveling for or temporary duty
The primary reason HR departments seek the Word format is editability. A Word document allows employers to pre-fill static details such as the company name, address, and employer code. This saves significant time when generating certificates for multiple employees, eliminating the need to write the same details by hand repeatedly.
: The employer provides the certificate of entitlement, including identification marks. Copy the table structure from this article into
While the official portal usually provides PDF versions, you can find editable formats or manual templates from specialized HR resource sites. Key Sections of ESIC Form 105
The dates the employee intends to stay at the temporary location.
Name of the employee, their father/husband’s name, and their Insurance Number (IP Number) .
: It serves as a travel pass for medical care, allowing an Insured Person (IP) on temporary duty or authorized leave to visit any ESIC dispensary or clinic nationwide. : The certificate is typically valid for a maximum of from the date of issue. Dual-Part Structure