Department of Empowerment of Persons with Disabilities,
Ministry of Social Justice and Empowerment, Government of India
Disability Certificate
Shri Shankarrao Chavan Government Medical College And Hospital, Nanded., Nanded,
Maharashtra
Certificate No.: MH1590620010418921 Date: 22/02/2024
This is to certify that I/We have carefully examined Shri Shaikh Samir Shaikh Najir Son of Shri Shaikh Najir, Date of
Birth 05/12/2001, Male, Registration No. 2715/00000/2402/0640623, resident of At Bhopalwadi Po Kalambar Bk
, Kalambar Bk, Nanded - 431715, Sub District Loha, District Nanded, State / UT Maharashtra
Whose photograph is affixed above, and I/We satisfied that:
(A) He is a case of Locomotor Disability
(B) The diagnosis in his case is RIGHT ABOVE KNEE AMPUTATION
(C) He has 80% (in figure) Eighty percent(in words) Permanent Disability in relation to his RIGHT LOWER LIMB as
per the guidelines (Guidelines for the purpose of assessing the extent of specified disability in a person included under
RPwD Act, 2016 notified by Government of India vide S.O. 76(E) dated 04/01/2018).
The applicant has submitted the following document(s) as proof of residence:
Nature of Document(s): Aadhaar card
Signature / Thumb Impression of the Person with Disability
Signature of notified Medical Authority Member
Shri Shankarrao Chavan Government Medical College And Hospital, Nanded.
Nanded, Maharashtra
This Card/Certificate is meant to certify the disability of the person and is not an instrument for ID/Address Proof for any purpose.
