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department of empowerment of persons with disabilities, ministry of social justice and empowerment, government of india

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117 views2 pages

Downloadapplication

department of empowerment of persons with disabilities, ministry of social justice and empowerment, government of india

Uploaded by

majhigayatri530
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: 19140000024030907095 Enrolment Date: 16/12/2024

PERSONAL DETAILS

Full Name in Regional


Name of Applicant GAYATRI MAJHI গায়ী মািঝ
Language
Applicant Father's Name SUNIL CHANDRA MAJHI Applicant Mother's Name SUBABALA MAJHI
Date of Birth 02/11/2006
[email protected]
Mobile Number 9382838337 E-Mail Id
m
Gender Female Category ST
Relation with PwD
Blood Group O- Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / SUNIL CHANDRA MAJHI Caretaker / Attendant / 7029146721
Related Related

Optional Details

Below Rupees 10000 Per


Personal Income (Annual) Highest Qualification Middle/Higher Primary
Annum
Employed or Unemployed Unemployed

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. ********4552

Address of Correspondence

Address Goria,Balarampur
Purulia - Ii Purulia
West Bengal 723202
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Speech and Language Disability
Disability Due To Congenital
Hospital Treating State / UTs West Bengal Hospital Treating District Purulia
Deben Mahata Government Medical College &
Hospital Name
Hospital

For more information please scan the QR code to


visit 'PwD Login'
This is computer generated receipt and does not require any signature.

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