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: 0620/00000/2308/1480623 Enrolment Date: 24/08/2023

PERSONAL DETAILS

Name of Applicant Aatul आवे दक का नाम अतु ल

Applicant Father's Name Ramesh

Applicant Mother's Name Devi

Date of Birth 25/05/2000 Age 23 Year(s)

Gender Male E-Mail Id ---------

Mark of Identification --------- Category General

Mobile Number 8448924208 Blood Group ---------

Marital Status ---------

Relation with PwD

Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Ramesh Caretaker / Attendant / ---------
Related Related

Address of Correspondence

Address House No 1472, Block C, Near Blue Bird School, Sgm Nagar Nit Faridabad, Faridabad, Faridabad, Haryana -
121001
Nature of Document Aadhaar Card
for Address Proof

Permanent Address

Address House No 1472, Block C, Near Blue Bird School, Sgm Nagar Nit Faridabad, Faridabad, Faridabad, Haryana -
121001

Educational Details

Highest Qualification ---------

DISABILITY DETAILS

Do you have disability certificate? Yes Disability Type Mental Illness

Sr. No. / Registration
Disability certificate uploaded? Yes 480
No. of Certificate
 Details of Issuing
Date of Issuance of Certificate 27/02/2008 Medical Authority
Authority
Disability Percentage ---------
Disability Area MENTAL ILLNESS (LEARNING),Mental Illness Disability Since
Pension Card Number ---------
Hospital Treating Disability --------- Disability Due To ---------
Hospital Treating State / UTs HARYANA
Hospital Treating District FARIDABAD
Hospital Name ---------

EMPLOYMENT DETAILS

Employed or Unemployed --------- Occupation ---------

BPL / APL ---------
Personal Income (Annual) ---------

IDENTITY DETAILS

Identity Proof Aadhaar Card

Aadhaar No. 802059625668

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