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PR-02 A (For Normal Scheme) Regn No. Sub code Month Year ...

PR-02 A. (For Normal Scheme). Employes's Name Regn No. Sub code Month Year Employer Total S. 1. Insured Person Registration No. 3. Old 5. Family Code Date Entry In No of days contrbution 6. Date Of Birth Date Exit Amount of Contribut No 2. Name / F-H Name 4. New Nadra d d m m y y y y d d m m y y y y wages ution ion 1 X X - - X X. 1. 2 - - 1 X X - - X X. 2. 2 - - 1 X X - - X X. 3. 2 - - 1 X X - - X X. 4. 2 - - 1 X X - - X X. 5. 2 - - 1 X X - - X X. 6. 2 - - 1 X X - - X X. 7. 2 - - 1 X X - - X X. 8. 2 - - 1 X X - - X X.

Total Contribut 2. Name / F-H Name 4. New N.I.C. Nadra ion: Date Exit. Amount of wages

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