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Disability Registration Document for Vihaan

This document provides registration details for Vihaan Mittal, a 4-year old male with a speech and language disability. It lists his personal details like name, father and mother's name, date of birth, address, and contact information. It also provides disability-related information such as the type and area of disability, treating hospital, and that the disability is hereditary in nature. Finally, it notes that Vihaan is unemployed and his family's annual income levels.

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govind samant
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352 views2 pages

Disability Registration Document for Vihaan

This document provides registration details for Vihaan Mittal, a 4-year old male with a speech and language disability. It lists his personal details like name, father and mother's name, date of birth, address, and contact information. It also provides disability-related information such as the type and area of disability, treating hospital, and that the disability is hereditary in nature. Finally, it notes that Vihaan is unemployed and his family's annual income levels.

Uploaded by

govind samant
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India


Acknowledgement / Resident Copy

Person with Disability Registration

Enrolment No: 0707/00000/1912/0641351 Enrolment Date: 12/12/2019

PERSONAL DETAILS

Name of Applicant Vihaan Mittal आवे दक का नाम VIHAAN

Applicant Father's Name Rakesh Mittal आवे दक के िपता का नाम ---------

Applicant Mother's Name Preeti Mittal आवे दक के माता का नाम ---------

Date of Birth 13/11/2015 Age 4 Year(s)

Gender Male E-Mail Id [email protected]

Mark of Identification --------- Category General

Mobile Number 9654628005 Blood Group ---------

Marital Status ---------

Relation with PwD


Mother
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Preeti Mittal Caretaker / Attendant / 9654628005
Related Related

Address of Correspondence

Address J110, Second Floor, Vikaspuri, Rajouri Garden, West, Delhi - 110018
पता ज ११०, Rajouri Garden, West, Delhi - 110018

Nature of Document Aadhaar Card


for Address Proof

Permanent Address

Address J110, Second Floor, Vikaspuri, Rajouri Garden, West, Delhi


पता Rajouri Garden, West, Delhi

Educational Details

Highest Qualification ---------

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Speech and Language


Disability
Disability Area --------- Disability Since 2015
Pension Card Number ---------
Hospital Treating Disability --------- Disability Due To Hereditary
Hospital Name Deen Dayal Upadhaya

EMPLOYMENT DETAILS

Employed or Unemployed Unemployed


Unemployed Since ---------
BPL / APL NA
Personal Income (Annual) Below 10000 Father Income (Annual) > 500000

IDENTITY DETAILS

Identity Proof Aadhaar Card TIN (NPR) ---------


Aadhaar No. 230086956842

This is computer generated receipt and does not require any signature.

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