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Disability Registration Receipt for Rajendra

The document is an acknowledgment of registration for a person with disability named Rajendra, who has a mental illness with a disability percentage of 75%. It includes personal details such as date of birth, contact information, and guardian details, along with information about the disability certificate issued by the Chief Medical Office. The document serves as a resident copy and is generated automatically without the need for a signature.

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shivajishivaji1280
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11 views1 page

Disability Registration Receipt for Rajendra

The document is an acknowledgment of registration for a person with disability named Rajendra, who has a mental illness with a disability percentage of 75%. It includes personal details such as date of birth, contact information, and guardian details, along with information about the disability certificate issued by the Chief Medical Office. The document serves as a resident copy and is generated automatically without the need for a signature.

Uploaded by

shivajishivaji1280
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: 295290000026010011952 Enrolment Date: 22/01/2026

PERSONAL DETAILS

Full Name in Regional ೕಂದ


Name of Applicant Rajendra
Language
Applicant Father's Name Manikarao Applicant Mother's Name
Date of Birth 01/01/1966
Mobile Number 9902239075 E-Mail Id
Gender Male
Relation with PwD
Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Manikarao Caretaker / Attendant / 9902239075
Related Related

Proof of Identity Card (See Instructions)

Identity Proof Ration Card Aadhaar No.

Address of Correspondence

Address Bhandar Kumta,Bhandar Kumta


Aurad Bidar
Karnataka 585326
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? Yes Disability Type Mental Illness


Disability certificate uploaded? Yes Sr. No. / Registration No. of Certificate 2025
Date of Issuance of Certificate 01/01/2025 Details of Issuing Authority Chief Medical Office
Disability Percentage 75
Disability Due To Congenital
Hospital Treating State / UTs Karnataka Hospital Treating District Bidar
Bidar Institute of Medical Sciences Teaching
Hospital Name
Hospital, Bidar

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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