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: 2727/00000/2309/1211391 Enrolment Date: 21/09/2023

PERSONAL DETAILS

Name of Applicant Areeb Asef Kazi आवे दक का नाम अरीब असे फ काझी

Applicant Father's Name Asef Applicant Mother's Name Tanveer

Date of Birth 18/04/2003 Age 20 Year(s)

Mobile Number 9960700846 E-Mail Id ---------

Gender Male Category General

Relation with PwD

Blood Group A+ Self
(Person with Disability)

Name of Guardian / Contact No. of Guardian /

Caretaker / Attendant / Self Caretaker / Attendant / 9960700846
Related Related

Optional Details

Personal Income (Annual) From 10000 To 100000 Highest Qualification Graduate

Employed or Unemployed Unemployed
Unemployed Since 18/09/2019

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. 976163188179

Address of Correspondence

Address Momin Pura, Georai, Beed, Georai, Georai, Beed, Maharashtra - 431127
Nature of Document for Aadhaar Card
Address Proof

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Low Vision

Disability Area BOTH EYE
Disability Due To Accident
Hospital Treating State / UTs MAHARASHTRA Hospital Treating District BEED
Hospital Name ---------
This is computer generated receipt and does not require any signature.