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: 27160000019020780984 Enrolment Date: 13/02/2019
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Pravin Sahebrao Dhabadge वीण साहे बराव धबड़गे
Language
Applicant Father's Name Sahebrao Applicant Mother's Name Vandana
Date of Birth 15/06/1996
Mobile Number 7350718734 E-Mail Id
Gender Male Category SC
Relation with PwD
Blood Group
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Caretaker / Attendant /
Related Related
Optional Details
Personal Income (Annual) Below 10000 Highest Qualification Graduate
Employed or Unemployed Unemployed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********5790
Address of Correspondence
Address At Jawala Tarfe Babhulgaon
,Jawala Traf Babulgaon
Vasmath Hingoli
Maharashtra 431512
Nature of Document Aadhaar card
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? No Disability Type Locomotor Disability
Disability Due To Accident
Hospital Treating State / UTs Maharashtra Hospital Treating District Hingoli
Hospital Name District Civil Hospital, Hingoli
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