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Disability Certificate

This document is a disability certificate issued by the Issuing Medical Authority in Kolhapur, Maharashtra. The certificate is for Sanskruti Sambhaji Magadum, a 6-year old female diagnosed with moderate intellectual disability. After examining her, the medical authority certified that she has 75% permanent disability related to her brain as defined in Indian government guidelines. The certificate documents her diagnosis and is meant to certify her disability.

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Eshav Saini
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4K views1 page

Disability Certificate

This document is a disability certificate issued by the Issuing Medical Authority in Kolhapur, Maharashtra. The certificate is for Sanskruti Sambhaji Magadum, a 6-year old female diagnosed with moderate intellectual disability. After examining her, the medical authority certified that she has 75% permanent disability related to her brain as defined in Indian government guidelines. The certificate documents her diagnosis and is meant to certify her disability.

Uploaded by

Eshav Saini
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
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Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India

Disability Certificate
Issuing Medical Authority, Kolhapur, Maharashtra

Certificate No.: MH3420920140091606 Date: 04/01/2021

This is to certify that I/we have carefully examined Kum. Sanskruti Sambhaji Magadum, Daughter of Shri Sambhaji
Satappa Magadum, Date of Birth 23/08/2014, Age 6, Female, Registration No.
2734/00000/2012/0166210, resident of House No. Gotan Galli, Naratawade - 416212, Sub District
Radhanagari, District Kolhapur, State / UT Maharashtra, whose photograph is affixed above, and I am/we are
satisfied that:

(A) She is a case of Intellectual Disability


(B) The diagnosis in her case is Moderate Intellectual Disability
(C) She has 75%(in figure) Seventy Five percent(in words) Permanent Disability in relation to her Brain as per the
guidelines (Guidelines for the purpose of assessing the extent of specified disability in a person included under RPwD
Act, 2016 notified by Government of India vide S.O. 76(E) dated 04/01/2018).

The applicant has submitted the following document(s) as proof of residence:


Nature of Document(s): Ration Card

Signature / Thumb Impression of the Person with Disability

Signatory of notified Medical Authority Member(s)

Issuing Medical Authority, Kolhapur, Maharashtra

This Card/Certificate is meant to certify the disability of the person and is not an instrument for ID/Address Proof for any purpose.

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