This document is a beneficiary registration form for the Pradhan Mantri Matru Vinyasa Yojana (PMMVY) program. It collects information such as the beneficiary's name, Aadhaar number, date of birth, mobile number, address, eligibility criteria, pregnancy details, childbirth details, and vaccination dates. The form includes 28 questions to gather these details for registering beneficiaries for the PMMVY program.
This document is a beneficiary registration form for the Pradhan Mantri Matru Vinyasa Yojana (PMMVY) program. It collects information such as the beneficiary's name, Aadhaar number, date of birth, mobile number, address, eligibility criteria, pregnancy details, childbirth details, and vaccination dates. The form includes 28 questions to gather these details for registering beneficiaries for the PMMVY program.
This document is a beneficiary registration form for the Pradhan Mantri Matru Vinyasa Yojana (PMMVY) program. It collects information such as the beneficiary's name, Aadhaar number, date of birth, mobile number, address, eligibility criteria, pregnancy details, childbirth details, and vaccination dates. The form includes 28 questions to gather these details for registering beneficiaries for the PMMVY program.
This document is a beneficiary registration form for the Pradhan Mantri Matru Vinyasa Yojana (PMMVY) program. It collects information such as the beneficiary's name, Aadhaar number, date of birth, mobile number, address, eligibility criteria, pregnancy details, childbirth details, and vaccination dates. The form includes 28 questions to gather these details for registering beneficiaries for the PMMVY program.
Name of SSK______________________________ASHA Name_________________________
1 Is beneficiary an employee of Central Govt., State Govt. YES / NO
or PSU? 2 Number of living children 0/1/2/3/4 3 Does the Beneficiary have Aadhaar Card? YES / NO 4 Name (As per Aadhaar)
5 Aadhaar Number (Attached the document)
6 Date of Birth 7 Age (in Years) 8 Category SC / ST / Others 9 Mobile Number (10 digits) 10 Eligibility Criteria ( Sl. No. Choose from below) 11 Identity No. (Attached the document) 12 MCTS/RCH ID 13 MCP Card Registration Date 14 Last Menstrual Period (LMP) Date 15 Ante-Natal Check-up (ANC) Date* 16 Has the child been born YES / NO 17 Actual Date of Childbirth 18 Address
19 State/District/Block WB/UD/ 20 Village (Census) 21 PIN Code 22 Number of Child Birth (Present Pregnancy) 1/2 23 Type of Institute of Child Birth 24 Name of Institute of Child Birth 25 Date of Vaccination (Birth Dose) 26 Date of Vaccination (6 Weeks) 27 Date of Vaccination (10 Weeks) 28 Date of Vaccination (14 Weeks)
1. Women whose net family income is less than Rs. 8 Lakh per annum 2. Women holding MGNREGA Job Card 3. Women farmers who are beneficiaries under Kishan Samman Nidhi 4. Women holding E-shram card 5. Women Beneficiaries under Pradhan Mantri Jan Aarogya Yojana (PMJAY) under Ayushman Bharat 6. Pregnant and Lacta ng AWWs/ AWHs/ ASHAs 7. Women holder of BPL ra on Card 8. Women who are par ally (40%) or fully disabled (Divyang Jan) 9. SC Women 10. ST Women 11. Women Beneficiaries holding the ra on card under Na onal Food Security Act 2013
