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: 02160000024070004092 Enrolment Date: 24/07/2024
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Sanjeev Kumar सं जीव कुमार
Language
Applicant Father's Name Nand Lal Applicant Mother's Name Veena Devi
Date of Birth 03/11/1983
Mobile Number 9418715995 E-Mail Id
Gender Male Category ST
Relation with PwD
Blood Group B+ Self
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Caretaker / Attendant /
Related Related
Optional Details
From Rupees 10000 To
Personal Income (Annual) Highest Qualification Senior Secondary
100000 Per Annum
Employed or Unemployed Unemployed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********6157
Address of Correspondence
Address Vill Kotha Post Office Bathri Teh
Dalhousie ,Dadra (84)
Dalhousie Chamba
Himachal Pradesh 176306
Nature of Document Aadhaar card
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? No Disability Type Hearing Impairment,Locomotor Disability,Low
Vision
Disability Due To
Hospital Treating State / UTs Himachal Pradesh Hospital Treating District Chamba
Hospital Name [Link] Chamba
For more information please scan the QR code to
visit 'PwD Login'
This is computer generated receipt and does not require any signature.
