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: 2918/00000/1912/0726577 Enrolment Date: 13/12/2019
PERSONAL DETAILS
Name of Applicant Helen Sheeba आवे दक का नाम Helen Sheeba
Applicant Father's Name Deeparaj M S आवे दक के िपता का नाम दीपराज म S
Applicant Mother's Name Mary Christina आवे दक के माता का नाम Mary Christina
Date of Birth 24/02/1981 Age 38 Year(s)
Gender Female E-Mail Id hsheeba24@[Link]
Mark of Identification --------- Category General
Mobile Number 7892692132 Blood Group B+
Marital Status Married Spouse Name Joseph Anthony Prakash
Relation with PwD
Self
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / --------- Caretaker / Attendant / ---------
Related Related
Address of Correspondence
Address 2174, 6th And 7th Cross, Yasin Nagar, Bangalore -, Bangalore North, Bengaluru Urban, Karnataka - 560043
पता 2174, 6th and 7th Cross, Yasin Nagar, Bangalore -, Bangalore North, Bengaluru Urban, Karnataka - 560043
Nature of Document Aadhaar Card
for Address Proof
Permanent Address
Address 2174, 6th And 7th Cross, Yasin Nagar, Bangalore -, Bangalore North, Bengaluru Urban, Karnataka - 560043
पता 2174, 6th and 7th Cross, Yasin Nagar, Bangalore -, Bangalore North, Bengaluru Urban, Karnataka - 560043
Educational Details
Highest Qualification Post Graduate
DISABILITY DETAILS
Do you have disability No Disability Type Hearing Impairment
certificate?
Disability Area Ears Disability Since 2005
Pension Card Number ---------
Hospital Treating
--------- Disability Due To Accident
Disability
EMPLOYMENT DETAILS
Employed or Unemployed Employed Occupation Private Jobs
BPL / APL NA
Personal Income (Annual) 100000 To 500000
Spouse Income (Annual) 100000 To 500000
IDENTITY DETAILS
Identity Proof Aadhaar Card TIN (NPR) ---------
Aadhaar No. 245956197027
This is computer generated receipt and does not require any signature.
