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: 213460000025010038562 Enrolment Date: 16/01/2025
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Raja Dalei राजा DALEI
Language
Applicant Father's Name Applicant Mother's Name Minati Dalei
Date of Birth 28/11/2003
Mobile Number 7682953547 E-Mail Id
Gender Male Category
Relation with PwD
Blood Group Mother
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Minati Dalei Caretaker / Attendant / 7682953547
Related Related
Optional Details
Personal Income (Annual) 0 Highest Qualification
Employed or Unemployed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********0377
Address of Correspondence
Address At/po-anko,ps-rupsa,Anko
Basta Baleshwar
Odisha 756028
Nature of Document Aadhaar card
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? No Disability Type Mental Illness
Disability Due To Congenital
Hospital Treating State / UTs Odisha Hospital Treating District Baleshwar
Hospital Name District Headquarter Hospital,Baleswar
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