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: 091300000024090021859 Enrolment Date: 27/09/2024
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Chameli Devi चमे ली दे वी
Language
Applicant Father's Name Man Singh Applicant Mother's Name Shola Devi
Date of Birth 01/01/1969
Mobile Number 8445216472 E-Mail Id
Gender Female Category SC
Relation with PwD
Blood Group Self
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Caretaker / Attendant /
Related Related
Optional Details
Below Rupees 10000 Per
Personal Income (Annual) Highest Qualification Primary
Annum
Employed or Unemployed Employed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********3129
Address of Correspondence
Address Khanjanpur Khanjaniya
Nawabganj Bareilly,Khanjanpur
Khanjania
Nawabganj Bareilly
Uttar Pradesh 262406
Nature of Document Aadhaar card
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? No Disability Type Blindness
Disability Due To Diseases
Hospital Treating State / UTs Uttar Pradesh Hospital Treating District Bareilly
Hospital Name COM office bareilly
For more information please scan the QR code to
visit 'PwD Login'
This is computer generated receipt and does not require any signature.
