Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India

Acknowledgement / Resident Copy
Enrolment No : 27220000019040432528 Date : 10/04/2019

Name, Address and other details Name, Address and other details_
Mayur Sanjay Ganage ( ) मयूर सं जय गनगे (Male_ )

B-401 Bldg 58 Ashtavinayak Chs Ltd New Mhada Tower

Near Atharv College Ekta Nagar

Date of Birth : 24/07/1997 Mobile : 7021736193

Email :

Address Proof Document :

ID Proof Document :

Hospital Name Hospital Address

---- Maharashtra, Mumbai Suburban

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