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: 09310000021100782525 Enrolment Date: 16/10/2021
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Sonu Babu सोनू बाबू
Language
Applicant Father's Name Tejram Applicant Mother's Name Manju Devi
Date of Birth 01/01/1992
Mobile Number 8393994133 E-Mail Id
Gender Male Category OBC
Relation with PwD
Blood Group Wife
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Reeta Devi Caretaker / Attendant / 9650625156
Related Related
Optional Details
Personal Income (Annual) From 10000 To 100000 Highest Qualification Primary
Employed or Unemployed Unemployed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********8404
Address of Correspondence
Address Kamandlapur,Kakrahi
Auraiya Auraiya
Uttar Pradesh 206244
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 111
Date of Issuance of Certificate 06/06/2017 Details of Issuing Authority Chief Medical Office
Disability Percentage
Disability Due To Accident
Hospital Treating State / UTs Uttar Pradesh Hospital Treating District Auraiya
Hospital Name ---------
This is computer generated receipt and does not require any signature.