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Disability Certificate Acknowledgment

This document is a registration acknowledgment for Suruj Kuenr Choudhury, a female person with a hearing impairment, issued by the Department of Empowerment of Persons with Disabilities in India. It includes personal details, contact information, and disability certification information, confirming a disability percentage of 60 due to diseases. The registration number is 213470000025040006847, and the document serves as a receipt without requiring a signature.

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155 views1 page

Disability Certificate Acknowledgment

This document is a registration acknowledgment for Suruj Kuenr Choudhury, a female person with a hearing impairment, issued by the Department of Empowerment of Persons with Disabilities in India. It includes personal details, contact information, and disability certification information, confirming a disability percentage of 60 due to diseases. The registration number is 213470000025040006847, and the document serves as a receipt without requiring a signature.

Uploaded by

before reality
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

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: 213470000025040006847 Enrolment Date: 17/04/2025

PERSONAL DETAILS

Full Name in Regional


Name of Applicant Suruj Kuenr Choudhury ସୁରଜ
ୁ କୁ ଏଁର େଚୗଧୁରୀ
Language
Applicant Father's Name Applicant Mother's Name
Date of Birth 26/12/1960
Mobile Number 9337310492 E-Mail Id THABIRSAI@[Link]
Gender Female
Relation with PwD
Husband
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Narayan Choudhury Caretaker / Attendant / 7008762353
Related Related

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. ********8804

Address of Correspondence

Address At-bada Saraipali, Po-


ruchida,Saraipali (bada)
Ambabhona Bargarh
Odisha 768045
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? Yes Disability Type Hearing Impairment


Disability certificate uploaded? Yes Sr. No. / Registration No. of Certificate 21031517625
Date of Issuance of Certificate 15/02/2015 Details of Issuing Authority Medical Authority
Disability Percentage 60
Disability Due To Diseases
Hospital Treating State / UTs Odisha Hospital Treating District Bargarh
Hospital Name District Headquarter Hospital, Bargarh

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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