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दिल्ली भवन एवं अन्य सद र्मा ण श्रदर्माक कल्या ण बोर्ड

DELHI BUILDING & OTHER CONSTRUCTION WORKERS WELFARE BOARD श्रम विभाग
LABOUR DEPARTMENT) विल्ली सरकार Govt.of NCT of Delhi ए-ब्लॉ क, 7िां तल, विकास भिन-II,
वसविल लाइं स, विल्ली -110054 A-Block, 7 Floor, Vikas Bhawan-II, Civil lines, Delhi-110054

District Office Address: Labour Welfare Centre Nimri Colony, Ashok


Vihar,Phase-IV Vikas Samuday Bhawan, Delhi-110052

District Name: 04-NORTH WEST

IDENTITY CARD / पहचान पत्र


पं जीकरण सं ख्या 51380000799482 पं जीकरण की तिति 22-03-2022
(Registration Number): (Date Of Registration):
1. सदस्य क न म(Name Of Member) JAGDISH YADAV
2. तपि क न म(Father Name) RAM SINGAR YADAV
3. म ि क न म(Mother Name) LACHI DEVI
4. पति/पत्नीी क न म(Spouse Name) Sunita devi
5. विम न पि (Local Address) 222 GALI NO-5 AMBEDKAR NAGAR
SHALIMAR BAGH North-West

6. स्थाि यी पि (Permanent Address) 222 GALI NO-5 AMBEDKAR NAGAR


SHALIMAR BAGH North-West

7. तिं ग(Sex) Male 8. वैव तिक स्थिस्थािति(Marital Status) Married


9. सदस्यि की अवति 2 Years 10. अगिी नवीनीकरण तिति
(Period Of Membership) (Next Renewal Date) 22-03-2024

11. जन्म की तिति 12. से व तनवृत की तिति


(Date Of Birth) 01-01-1993 (Date Of Retirement) 31-12-2052

पररिार के सिस्य, नामां वकत व्यक्ति , बच्चेे का वििरण(Details of (Family Members, Nominee,
Children))
क्रम सं . सिस्य जन्म क वतवि वलं ग नामां वकत शेयर ररश्ताा वशक्षाा वििरण
(S No.) (Name) (DOB) (Sex) (Nominee (Relation) (Education Detaills)
Share)
कक्षाा स्कूल/क ले ज
(Class) ई नाम, कोड
और पता
(School/College
name, code
and address)

1 sunita devi 01-04-1990 Female 100.00 % Wife

2 shivansh yadav 30-09-2016 Male Son

3 devansh yadav 02-10-2010 Male Son

NOTE:
1.This Certificate is valid as per Information Technology Act 2000 as amended from time to time.
2.The Authenticity of this document should be verified at https://dbocwwb.delhi.gov.in. Any discrepancy in the
details on this document when compared to those available on the website renders it invalid.
3.The onus of checking the legitimacy is on the users of this document.
4.In case of any discrepancy please inform the authority issuing this Certificate.

22-Apr-2024 06:43:15 AM Page 1 of 2


पं जीकरण सं ख्या सदस्य क न म
(Registration Number): 51380000799482 (Name of Applicant) JAGDISH YADAV

भ ग-िीन
तनयोजन क तववरण

उस तनयोजन के प्रा रं भ िि सम स्थि की


स्थाि पन/तनम ण तिि तिक री ि रीख तनयोि य
व स्ततवक
क य क तववरण तनयोजक क द्वा र तकये गए अतिक र
क्र. स. तनयोजन के तदनों
और पि , जि ँ न म िि पि क य की प्राकृति प्रातितनति के
की सं ख्या
तिि तिक री िि पदन म िस्त क्षर
प्रा रं भ सम स्थि
तनयोतजि िै

1 2 3 4 5 6 7 8

NOTE:
1.This Certificate is valid as per Information Technology Act 2000 as amended from time to time.
2.The Authenticity of this document should be verified at https://dbocwwb.delhi.gov.in. Any discrepancy in the
details on this document when compared to those available on the website renders it invalid.
3.The onus of checking the legitimacy is on the users of this document.
4.In case of any discrepancy please inform the authority issuing this Certificate.

22-Apr-2024 06:43:15 AM Page 2 of 2

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