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GOVERNMENT OF RAJASTHAN

DEPARTMENT OF MEDICAL AND HEALTH


Disability Certificate (Form-II)
Certificate No.SAP/2021/1245690 Date:20-01-2024

This is to certify that I have carefully examined Shri/Smt./Kum. DHANRAJ


BISHNOI son/ wife/ daughter of Shri JITURAM BISHNOI Date of Birth(DD / MM /
YYYY) 01/01/1975 Age 49 years, Male Registration No SAP/2021/1245690
Permanent resident of Street 01 Area MADIYA Village MADIYA Grampanchayat
BEEKASAR Panchayatsamiti NOKHA Tehsil NOKHA District BIKANER State
RAJASTHAN whose Photograph is affixed and am satisfied that:

1. (A) He is a case of: LOCOMOTOR DISABILITY


(B) The diagnosis in his case is POST TRAUMATIC ANKYLOSIS RIGHT ANKLE
(C) He has 43 % (in figure) Forty Three percent (in words) PERMANENT physical
impairment in relation to his RIGHT UPPER LIMB (part of body) as per guidelines (to be
specfied).

Signature Not Verified


Digitally signed by Mohd. Abrar Panwar
Designation : CMHO
Date: 2024.01.20 01:34:01 IST
Reason: Approved
Location: BIKANER

Note: This is a digitally signed certificate and does not required any physical signature.

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