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: 2721/00000/2110/1744682 Enrolment Date: 29/10/2021

PERSONAL DETAILS

Name of Applicant Savan Gurudas Anvekar आवे दक का नाम सवम गु दास अवे कर

Applicant Father's Name Gurudas आवे दक के िपता का नाम गु दास

Applicant Mother's Name Sunita आवे दक के माता का नाम सु नीता

Date of Birth 25/04/1976 Age 45 Year(s)

anvekarsavan693@gmail.co
Gender Male E-Mail Id
m

Mark of Identification --------- Category General

Mobile Number 9324127118 Blood Group ---------

Marital Status Married Spouse Name Milan

Relation with PwD

Husband
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Milan Caretaker / Attendant / 7498732747
Related Related

Address of Correspondence

Address 604 Daffodill, Satguru Gardens, Kopri Colony, Thane, Thane, Maharashtra - 400600
पता ठाणे ईट, Thane, Thane, Maharashtra - 400600

Nature of Document for Passport

Address Proof

Permanent Address

Address 604 Daffodill, Satguru Gardens, Kopri Colony, Thane, Thane, Maharashtra - 400600
पता ठाणे ईट, Thane, Thane, Maharashtra - 400600

Educational Details

Highest Qualification Graduate

DISABILITY DETAILS

Do you have disability No Disability Type Parkinson's Disease

certificate?
 Chest,Hand Fingers,APRAXIA
OF SPEECH,FINGERS,BOTH
Disability Area LEG,BOTH LOWER LIMB,BOTH Disability Since 2005
UPPER LIMB,WHOLE
BODY,Both Hand
Pension Card Number ---------
Hospital Treating
CRITY CARE HOSPITAAL Disability Due To Diseases
Disability

EMPLOYMENT DETAILS

Employed or Unemployed Unemployed

Unemployed Since 05/10/2017
BPL / APL NA
Personal Income (Annual) Below 10000
Spouse Income (Annual) From 10000 To 100000

IDENTITY DETAILS

Identity Proof Aadhaar Card TIN (NPR) ---------

Aadhaar No. 370792610777

This is computer generated receipt and does not require any signature.