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    kaedeharakazuha8767
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    Copyright:

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

    Downloadapplication

    Uploaded by

    kaedeharakazuha8767

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    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: 274840000024070010553 Enrolment Date: 17/07/2024

    PERSONAL DETAILS

    Full Name in Regional


    Name of Applicant Priti Kishor Gajbhiye ीित िकशोर गजिभये
    Language
    Applicant Father's Name Kishor Narayan Gajbhiye Applicant Mother's Name Sarita Gajbhiye
    Date of Birth 30/05/2002
    Mobile Number 8767430307 E-Mail Id [email protected]
    Gender Female Category SC
    Relation with PwD
    Blood Group O+ Mother
    (Person with Disability)
    Name of Guardian / Contact No. of Guardian /
    Caretaker / Attendant / Sarita Gajbhiye Caretaker / Attendant / 8767430307
    Related Related

    Optional Details

    From Rupees 10000 To


    Personal Income (Annual) Highest Qualification Graduate
    100000 Per Annum
    Employed or Unemployed Unemployed

    Proof of Identity Card (See Instructions)

    Identity Proof Aadhaar Card Aadhaar No. ********6080

    Address of Correspondence

    Address Waghoda New Hotment Colony


    Qt No.314,Savner
    Savner Nagpur
    Maharashtra 441107
    Nature of Document Aadhaar card
    for Address Proof

    DISABILITY DETAILS

    Do you have disability certificate? No Disability Type Low Vision


    Disability Due To Infection
    Hospital Treating State / UTs Maharashtra Hospital Treating District Nagpur
    All India Institute of Medical Sciences (AIIMS),MIHAN
    Hospital Name
    Nagpu

    For more information please scan the


    QR code to visit 'PwD Login'
    This is computer generated receipt and does not require any signature.

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