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Disability Registration Receipt - India

The document is a registration acknowledgment for a person with a disability named Nagendra Basavattige, enrolled on 10/11/2022. It includes personal details such as date of birth, contact information, and disability information, indicating an intellectual disability due to diseases. The document serves as proof of identity and address, with no signature required as it is computer-generated.

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Lovly Dhruv
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23 views2 pages

Disability Registration Receipt - India

The document is a registration acknowledgment for a person with a disability named Nagendra Basavattige, enrolled on 10/11/2022. It includes personal details such as date of birth, contact information, and disability information, indicating an intellectual disability due to diseases. The document serves as proof of identity and address, with no signature required as it is computer-generated.

Uploaded by

Lovly Dhruv
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: 29230000022110646334 Enrolment Date: 10/11/2022

PERSONAL DETAILS

Nagendra Basavattige Full Name in Regional ೕಂದ ಬಸವ ವಣ


Name of Applicant
Shivanna Language
Applicant Father's Name Shivanna Applicant Mother's Name Shivanagamma
Date of Birth 18/06/1997
Mobile Number 9740435463 E-Mail Id
Gender Male
Relation with PwD
Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Shivanna Caretaker / Attendant / 9740435463
Related Related

Optional Details

Personal Income (Annual) Below 10000 Highest Qualification Primary


Employed or Unemployed

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar No. ********4261

Address of Correspondence

Address Basavattige Doddakavalande


Hobli Nanjanagudu Talluku
Mysore District,Basavattige
Nanjangud Mysuru
Karnataka 571312
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Intellectual Disability


Disability Due To Diseases
Hospital Treating State / UTs Karnataka Hospital Treating District Mysuru
Hospital Name [Link], Mysuru

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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