The Employees State Insurance Corporation (ESIC) of India is one of the largest social security organizations providing medical insurance cover and delivering of medical care to 35 million beneficiaries through 140 hospitals and 1500 dispensaries. The objectives of this study are to understand the costing of medical care at ESI hospitals and suggest systems for e-governance to facilitate the coordination between ESIC, ESIS and the beneficiaries. Towards this, we selected a large ESI hospital, namely, the ESI General Hospital at Bapunagar, Ahmedabad and gained very useful insights about the systems currently in practice for offering medical benefits to the insured persons and their beneficiaries. This working paper brings out our detailed analysis of the working of ESI hospital, Bapunagar in delivering medical care under the ESI scheme.