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 ORPOFINDIA
SECTOR.NO.47, 001
Bengaluru-560
NEAR BAPDEV 1947
412101
-Maharashtra No.19
DEHUROAD,
NAGAR,
NURSARY
GAIKWAD Box
GDYEAHMENTOFHO
DOB:
t220G1976 NARAYAN, P.Q
6483
8304
1302 AddresS www.idai.gov.in
DEWACARONA
NQUE
ANN
fT
FEMALE LAXMI
Pune,
Viie
Narayan
Nandgeonkar
helpudaigov.n
s,y,
TheTE
412101
HEUg-
TRT,
atTK, 1947
300
1800
194
3TET
T
f
 ANMe (CstihestettADM)

Governnwst as Malarashira
Dlsabllity
(ncases othey lhan those Certificate
nentioed n Poms Il and )(See nule 4)

NAMIE OP THE HOSPITAL:

Sasoon lHospltals, Pune
(Maharashua, India)
Cenificate Numbe: 342932
Date: 03/II2016

This is to cenifythat I uve carefully exained.

Person Jdentification Number: PI52100475748
Aadhar Number: N/A
Shri/Smt./Kum: NANDGAONKAR VINITANARAYAN LAXMIBAI
Father Name: Shri/Smt/Kun. NARAYAN
Date of Birth (dd/n:n/yyyy): 22I06/197(G Age: 40 yeors
Gender: Female
Permanent Addres:
House Address: NEAR GAIKWAD NURSUFYSECTOR NO-47,BAPDEV NAGAR DEHUROAD.KTWALE
Village: Haveli Taluka: Haveli
District: Pune Pincode: 412101
whose photograplh is affixed above, and am satisfied that he / she is acase of Physical Impairment
disabiliy. His / Her extent of percentage physical irapaiment /disability has been evaluated as per guidelines
and is shown against the relevant disabiliuy in the table below :
Disability Affected part ofPody Diagnosis Disability (in %)
LL UL,LL IL cerebral palsy left hemiplegic type 53
Plysical Impairment
1, The Above conditlon is Perimanent, non-progressive, not likely to improve
2. Reassessnent of disability
residence: Aadhar Card
3. The applicant has subrmitted following documents as proof of
ldentity: Aadhar Card
4.The applicant has subinitted following docu-nents as proof of
(Signature and Seal of Authorised Signatory of notified Mediçáa,uchorit

DR. K} Baisd(KynaRTHO) BANSAL Dr.Sitehal Kishor Wadekar Dr. Ajay ATaware

M.SORTIOEN Medical Superlntendent and
R.M.O. Chairnan Disability Board
M NOtbópedit'
REG. Surgeoht Class-lI
N) 2C4""S13 President
ASSISTANTMembecSSOR Member Secretary
Regn. No.:2001/01/0298
DEPRQHi. N&F2O09O5A5 Regn. No. :2016/05/0954
ResidetMedical e:
Taware
B.J MC & S.GII is issee Ajay A. MD. (F.M.,T
nose favOHr di_ability eertificate
Signature/Thumb impression of the person Reg. i .
cases.
Note: This is not valid for Medico Legal Sunar
Sassoon Generat iospieiPune,

11/03/2016 12:28 PM
ABnxurg HB a|cENTRAL RÁLWAÝ
INSTRUCO 2978
FAMILY IDENTJTYCARD
RetlM(rard rye
Thls ideadey Cndshoid eled by he
ForComplimentary Pass)
spouedependent
and Prodced on
chlldren dalouray agNOTTRANSFERABLE
demand by the Tlcdot
checkln ttaf.
Name of retired<deceased
Ayn..I4nM.
Emplgyee
2.

Tavelidng on Name of Spauze MS..SAKD.Ibj

che ldede CardCompmwtany Pas
wt be created s without
tarellg
wBthoue clcket adk llable for penatey
3

the nges. under Signagure/thumb lmpresslon

of che spouse

4.

Signature/Thumb impression of Employee

(for retiring employees)
Misefldeecity
Pass willaue CnsandjorComplaoatary
cfwtchdawal phé 5.
witho netkg. hls ldentity Card is valld uptoy

In se of loss of this ldentity Card, itsho gareT ( af

be reporte to cie kogAuchorty Issulng officer
diately & cart Pollce Staton. (yleh Seal)
 fR
An DETAILS OF FAMILY Rlatlonshlp
Incdutin Dependants
o6247Õ
(oong& daughters on)
Th
«/Name
ch

shr Naayan Tahy o n|Sef

Net helychk:Ny 56 Y wife
the
wit!
inst- lexmibdi Neeye
the
m'ss Vipta Narayeln
3.
Cartify that the lafotmaten glvea bove
Is correct.
R
Mis sfa/-f
Slgnature of
Pass
facli
sgnature of leyee
4.
frs/Date.
be re
íatei
 e.HNo..... o¬2478 6./No..

a/NeneA..NaAYAih..44h
Nardgaof A{iijbaie oi Eirth...
KatafsyDareol Birth-.Q9.42. n.--:

Issulrg Officer's
SlgHarure 8Date
Signsüte
 Blrhak
Tat/Date of O62478
e &

/No..e

Oflcers
Date

JDate
Birthof
Depandant
Chia)(of
PHØTOGRAPN

Signature
Date & ./No.
OMcer'
Iulngs
 Vanjare
Shruti
SighatureOf identilied
Signed Haveli
Name:
Tehsil Appl1cant AffidavitNo
Nandgaonkar :
Date:2352141931268501645853
06/07/2023
AM
and
by Name
ldentifier ShriSworn
/ :
Smtbefore Laxmibai
Kumari / by
Shrimati Narayan
aecACl204&ag Shruti
Laxmibai
Vanjare

Narayan
whose

signature
Nindeionkar
is

Ezecatlve
aboul
blank
hereby

appended.yois 1268

Sonally 23070
known
6
Exechtive
Magistrate
Special to 200
me
or 2925
06/07/2023
Date : who
has
6
bcer 2
Haveli
5

1/1
nL

who 06/07/2023
Signed : TensilApplicant AffidavitNo
DateNandgaonkar
2352141931268501645853 : punishmentpenalty
Date Place true
Shrimati I
Date Place
The sign I The
ToStamp
Unemployment ThiAffidavit:
s ReasonFor Address
Occupation Applicant
Age Name
has and information statements Be affidavit
Name this
been and Name correct Sumbited Papar
Sworn Laxmibai affidavit
identified Haveli : No.:-50AA attached
to
before Laxmibai : the
stated made ,Unmarried
underNarayan on IN
best the abovePension
by
by
Haveli :
06/07/2023 : above
608200
with :76
Laxmibai : THE
Kumari Narayan Section193(2),199 of 06/07/I2023 Haveli day Housewife
And -
100/ Pimpri
Shrimati my
Nandgaonkar is of are PRESENCE
whose knowledge true
06/07/2023 true Office.
SurvivalStamp Chinchawad Nandgaonkar
Laxmibai
signature
and
correct
& Narayan
and
correct Paper OF
&
solemnly at Status.
Narayan 200
is anythingof
ifDeclaration to Pune.
the
to Purpose (Municipal HON'BLE
hereby the affirm
the
andgaonkar best best Haveli
Indian Of
appended. contray that
Penal
of
my
of
my Employee Corporation.) EXECUTIVE
the
to
details knowledge.Hence knowledge
who Code. the
above is
personally
is

Signature of
furnished

found,
and
belie.
Declaration
For
Haveli 12682307062002
MAGISTRATE 925625
AffidaviRolder
in Signature of
known
lI
the
wiabove
this
Pune, ,
Affidavit
to Affidavit be Of COURT,
me liable
Affidavit Daughters 412101
or is
Holder for made
is
 ENE

LaxmiNarayan,
hercby I, MAHARASHTRA1001001O01O0
1O01O01O010o
LaxmibaiDAUGHTER'S
1.
Narayan,
unemployed
and , solemnly
Miss. AFFDAVIT 881INDIA
JUDICIAE
91QQ1O010O100OO1o01001001991
Q212S NON
Near
Vinita
declare Near
Narayan

UNEMPLOYMENT, 953o1S3 10 7.
Narayan -Nandgaonkar
Gaikwad
Gaikwad
have as FROM
no
under bnNeELR,9/9/R0c%)
Nandgaonkar Nursery,
source
Nurscry, EMPLOYEE RNDIAo190190108
wife 20220 O
of STATUS.
income Bapdev of
Bapdev late.
born Narayan UNMARRIED
from Nagar, FOR
Nagar, on
any DECLARATION
22/06/1976 Dehuroad, Tanu HUNDRED'
RUPEES
source.
Dehuroad,
Nandgaonkar, AND
Rs.100
residing
Pune
Pune
412101,
SURVIVAL 1O0TO0
ONE
OF 608200
50AA
412101 at residing
Laxmi do KZAIYZ 1
is at
 Date :Place :code.
affidavit
I I, DatePlace:
:
wil Laxmibai nothing authorities.
Whatsoever make I
be 3. Z.
liable is has thisdaughter unmarried
Narayan, Miss/
true Narayan, Miss.
Narayan been stated
above is affidavit
for and
punishmentpenaltycorrect concealed Ison, Vinita Vinita
Near and Near
Nandgaonkar in and singe
to
order GaikwadNarayan GaikwadNarayan
is
the therein. survival till
correct to
best confim date.
Declaration Hence Nandgaonkar
Nursery, Nandgaonkar
Nursery,
of
under solemnly and and
my the next
knowledge
section this true
above Bapdev Bapdev
affirm affidavit to to
the kin born
193(2), facts
afterNagar,
born
and that is
best
so
Nagar,
on on
199 if the
anything
made. of as
my
22/06/1976 Dehuroad,
and
details my todemise.
Dehuroad, 22/06/1976
Signature
affiantof Signature
affiantof knowledgeand submit
200 furnished
contrary
of bcfore
the Puneresiding Puneresiding
Indian to in the
be the beliefand concerned 412101l 412101
at at
penal found, above
Laxmi
is isLaxmi
my stil
o:35 AM
 Magi
Edeculve
Speci
st06/raatDatl e07/e:2023
Haveli
808 been
2002925 hm
who
or
me
706 to
hiscflonlyknown
1208230
appendeu.
salpcel2oucl
aloul
lank
hercby
SPecla,G Nandeaonkar
is sigoature
whuse
Naayan
Vanjare
Vinitu
Shrud
kumari
Naravn
Tnita
\NName Aunnai
by
hne
St
Shwn
Shu \anjare
Shrui
\antgaonkar andby
til
Sgt
 about:blank
i 3 , T0 34 ANM

1268 230706200 292 5 8 0 A

MAGISTRATE COURT,
IN THE PRESENCE OF HON'BLE EXECUTIVE
Havell

Applicant Name Vinita Narayan Nandgaonkar

Ago :47
Occupation Housewife
Addross :"Pimpri Chinchawad (Municipal Corporation.), Haveli , Pune, 412101

Reason For Affidavit:

This afidavit attached with 100/- Stamp Paper Purpose of Daughter Stating That She Will Inform
Administration Whenever She Gets Married Or Employment
Stamp Papar No.:-50AA 608199
To Be Sumbited Pension Office.
The statements made above are true &correct to the best of my knowledge and
beliet.
Isign this affidavit on the day of 06/07/2023 at Pune.

The infomation stated above is true and correct to the best of my

knowledge.Hence this Affidavit is made:

Place Haveli
Date 06/07/2023

Signature ofAffidavit Holder

Declaration

IKumari Vinita Narayan Nandgaonkar solemnly affirm that the details furnished in the above Affidavit is true
andcorrect to the best of my knowledge and if anything contray to the above is found, I willbe liable for
punishmentpenalty under Section 193(2),199 &200 of the Indian Penal Code.

Place Haveli
Date 06/0712023

Signature 6fAffidavit Holder

Affidavit No:
2352141931268501645869
Applicant Name: Vinita Narayan
Nandgaonkar
Tehsil Name: Haveli

Date : 06/07/2023

Signed and Sworn before by KumariVinita Narayan Nandgaonkar who is personally known to me or who has
been identified by Kumariwhose signature is hereby appended.
ahut hlank 1/2
 Rs. 100
ONE
6. 100 HUNDRED'RUPEES

HIRT INDIA
INDIA NON JUDICIAL
5044 608199
20220
HERI MAHARASHTRA

AFFIDAVIT FROM DAUGHTER STATING THAT SHE WILL

INFORM ADMINISTRATION WHENEVERSHE GETS MARRIED OR
EMPLOYMENT

,Vinita Narayan Nandgaonkar daughter of late. Narnyan Tanu Nandgaonkar, residing

At LaNniNarayan, Near Galkwad Nursery,Bapdev Nagar, Deburoad, Pune 412101, do
herehy selemnly declare as under
 Date : Place : code.
affidavit
will I 1,
Vinita Date: Place : nothing authorities.
idtsoeVer
stated
above ake
be
liable is di 1.I
Narayan
true has nis Iwill Hrlyan,
unemployed,
for and been atfidavit am
punishment/penalty correct
concealed
inform
Nandgaonkar Vinita
in Near
to order unmarried
adnninistration
the therein.
correct
is GaikwadNarayan
best to
solemnly confirm and
under ofDeclaration Hence
my
knowledge affirm
section
and
true above
factsthe
ave
Nandgaonkar Laxmi
whenever lhNursery,
this no
affidavit to source
193(2), that the wil I Bapdevy
and
the best get of born
is so income Nagar,
199 if made. of married on
anything details as
Signature
affiantof and my submit
beforeto
200 furnished Signature
affiantof knowledge
from
Dehuroad,
or 22/06/1976
contrary employment any
of
the source.
Indian to in
be the
and
concernedthe
Puneresiding
penal found, above belief
412101 at
and
is