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: 0706/00000/2306/0481671 Enrolment Date: 08/06/2023

PERSONAL DETAILS

Name of Applicant Kashif आवे दक का नाम KASHIF

Applicant Father's Name Md Saheb Applicant Mother's Name Shahana Khatoon

Date of Birth 14/02/2017 Age 6 Year(s)

Mobile Number 9910725713 E-Mail Id mdsaheb9091@gmail.com

Gender Male Category General

Relation with PwD

Blood Group --------- Other
(Person with Disability)

Name of Guardian / Contact No. of Guardian /

Caretaker / Attendant / Md Saheb Caretaker / Attendant / 9910725713
Related Related

Optional Details

Personal Income (Annual) --------- Highest Qualification Primary

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

Proof of Identity Card (See Instructions)

Current Passbook Of Post

Identity Proof Aadhaar No. 276069888764
Office/any Scheduled Bank

Address of Correspondence

Address 6967,third Floor, Shankar Marg,, Multani Dhanda, Pahar Ganj,, Central Delhi, Delhi-110055, Pahar Ganj, Central,
Delhi - 110055
Nature of Document for Current Passbook Of Post Office/any Schedule Bank
Address Proof

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Locomotor Disability

Disability Area ---------
Disability Due To Congenital
Hospital Treating State / UTs DELHI Hospital Treating District CENTRAL
Hospital Name Lok Nayak Hospital
This is computer generated receipt and does not require any signature.