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The document is a registration acknowledgment for Mukesh Bhardwaj, a person with a locomotor disability, issued by the Department of Empowerment of Persons with Disabilities in India. It includes personal details such as his father's name, date of birth, contact information, and disability certificate information. Mukesh is categorized as OBC, has an annual income between 10,000 to 100,000, and is currently employed.

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48 views2 pages

Downloadapplication

The document is a registration acknowledgment for Mukesh Bhardwaj, a person with a locomotor disability, issued by the Department of Empowerment of Persons with Disabilities in India. It includes personal details such as his father's name, date of birth, contact information, and disability certificate information. Mukesh is categorized as OBC, has an annual income between 10,000 to 100,000, and is currently employed.

Uploaded by

pbhim9981
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


Acknowledgement / Resident Copy

Person with Disability Registration

Enrolment No: 09660000018080061325 Enrolment Date: 02/08/2018

PERSONAL DETAILS

Full Name in Regional


Name of Applicant Mukesh Bhardwaj मु केश भाराज
Language
Applicant Father's Name Ghanshyam Bhardwaj Applicant Mother's Name Kalavati Devi
Date of Birth 10/04/1995
Mobile Number 9336918372 E-Mail Id
Gender Male Category OBC
Relation with PwD
Blood Group Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Ghanshyam Bhardwaj Caretaker / Attendant / 9336918372
Related Related

Optional Details

Personal Income (Annual) From 10000 To 100000 Highest Qualification Middle/Higher Primary
Employed or Unemployed Employed

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. ********8924

Address of Correspondence

Address Village-Chhitampur, Kadipur,


Post-Chaubeypur, Police
Station-Chaubeypur, Block-
Cholapur, District-
Varanasi,Chhitampur
Varanasi Sadar Varanasi
Uttar Pradesh 221104
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 635
Date of Issuance of Certificate 02/07/2014 Details of Issuing Authority Chief Medical Office
Disability Percentage 50
Disability Due To Accident
Hospital Treating State / UTs Uttar Pradesh Hospital Treating District Varanasi
Shree Shiv Prasad Gupt Divisional District
Hospital Name
Hospital, Kabirchaura

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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