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    Application 07060000023060481671 1706631390

    Uploaded by

    Aamir liam
    This document is a registration form for a person with disabilities named Kashif. It provides Kashif's personal details like name, father's name, date of birth, address, as well as disability details including the type of disability (locomotor), cause (congenital), and treating hospital. The form serves to acknowledge and register Kashif in the database of the Department of Empowerment of Persons with Disabilities in India.

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    Download as PDF, TXT or read online from Scribd

    Application 07060000023060481671 1706631390

    Uploaded by

    Aamir liam
    16 views2 pages
    This document is a registration form for a person with disabilities named Kashif. It provides Kashif's personal details like name, father's name, date of birth, address, as well as disability details including the type of disability (locomotor), cause (congenital), and treating hospital. The form serves to acknowledge and register Kashif in the database of the Department of Empowerment of Persons with Disabilities in India.

    Original Description:

    Data from delhi and help

    Original Title

    application_07060000023060481671_1706631390

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    This document is a registration form for a person with disabilities named Kashif. It provides Kashif's personal details like name, father's name, date of birth, address, as well as disability details including the type of disability (locomotor), cause (congenital), and treating hospital. The form serves to acknowledge and register Kashif in the database of the Department of Empowerment of Persons with Disabilities in India.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    16 views2 pages

    Application 07060000023060481671 1706631390

    Uploaded by

    Aamir liam
    This document is a registration form for a person with disabilities named Kashif. It provides Kashif's personal details like name, father's name, date of birth, address, as well as disability details including the type of disability (locomotor), cause (congenital), and treating hospital. The form serves to acknowledge and register Kashif in the database of the Department of Empowerment of Persons with Disabilities in India.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    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.

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