Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India

Acknowledgement / Resident Copy
Enrolment No : 0926/00000/2001/0310886 Date : 06/01/2020 21:44:39

Name, Address and other details नाम, पता और अय िववरण

Jayant Kumar Singh (Male) जयं त कुमार िसं ह (पु ्ष)
Late Shishupal Singh (Father) वगीय िशशु पाल िसं ह (िपता)

647a/019h, Shivalik Vihar, Gudian Purwa, Sector-h, ६४७◌ा /०१९ह , िशवािलक िवहार , गु ड़ीआं पु रवा, से टर -ह ,
Jankipuram, Behind Arihant Hospital, Lucknow, U.p., जानकीपु रम , िबहाइं ड अिरहं त हॉिपटल, लखनऊ , U.P., Lucknow,
Lucknow, Lucknow, Uttar Pradesh - 226021 Lucknow, Uttar Pradesh - 226021

Date of Birth : 10/10/1966 Mobile : 9415782093

Age : 53 Year(s) Email : jayantkumarsingh1966@gmail.com

Address Proof Document : Aadhaar card

ID Proof Document : Aadhaar Card

For enquiry, please contact :

http://www.swavlambancard.gov.in 1) - cmolko@up.nic.in MO Address: 1) - Chief Medical Officer, Lucknow

This is computer generated receipt and does not require any signature.