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Disability Registration Receipt for Deep Das

This document is a registration acknowledgment for a person with a disability named Deep Das, born on 23/10/2007, with a locomotor disability certified at 60%. The registration includes personal details, contact information, and the disability certificate issued by a medical authority in West Bengal. It serves as a formal record of the individual's enrollment under the Department of Empowerment of Persons with Disabilities, Government of India.

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23 views1 page

Disability Registration Receipt for Deep Das

This document is a registration acknowledgment for a person with a disability named Deep Das, born on 23/10/2007, with a locomotor disability certified at 60%. The registration includes personal details, contact information, and the disability certificate issued by a medical authority in West Bengal. It serves as a formal record of the individual's enrollment under the Department of Empowerment of Persons with Disabilities, Government of India.

Uploaded by

tsk55943
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: 193070000025100027282 Enrolment Date: 22/10/2025

PERSONAL DETAILS

Full Name in Regional


Name of Applicant Deep Das দীপ দাস
Language
Applicant Father's Name Nilmani Das Applicant Mother's Name
Date of Birth 23/10/2007
Mobile Number 9332579881 E-Mail Id
Gender Male
Relation with PwD
Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Nilmani Das Caretaker / Attendant / 9332579881
Related Related

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. ********3844

Address of Correspondence

Address Sukbazar,
Siyan,,Dwarkanathpur
Bolpur Sriniketan Birbhum
West Bengal 731204
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? Yes Disability Type Locomotor Disability


Disability certificate uploaded? Yes Sr. No. / Registration No. of Certificate BSDH/104393
Date of Issuance of Certificate 21/07/2020 Details of Issuing Authority Medical Authority
Disability Percentage 60
Disability Due To
Hospital Treating State / UTs West Bengal Hospital Treating District Birbhum
Hospital Name Sub Division Hospital-Bolpur

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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