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: 295250000024050022711 Enrolment Date: 28/05/2024

PERSONAL DETAILS

Full Name in Regional ಎಂ ಅನು 

Name of Applicant Md Ashanulla Khan
Language
Applicant Father's Name Basir Ahmed Khan Applicant Mother's Name Fayejakhatun Khan
Date of Birth 05/10/1994
mdashanulla1994@gmail.co
Mobile Number 8190928663 E-Mail Id
m
Gender Male Category General
Relation with PwD
Blood Group A+ Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Basir Ahmed Khan Caretaker / Attendant / 8884671388
Related Related

Optional Details

From Rupees 10000 To

Personal Income (Annual) Highest Qualification
100000 Per Annum
Employed or Unemployed Employed

Proof of Identity Card (See Instructions)

Identity Proof Aadhaar Card Aadhaar No. ********0378

Address of Correspondence

Address Attibele Anekal Road

Bhuvaneshwari Nagar
Bangalore 562107,Attibele (ct)
Anekal Bengaluru Urban
Karnataka 562107
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? No Disability Type Mental Illness

Disability Due To Diseases
Hospital Treating State / UTs Karnataka Hospital Treating District Bengaluru Urban
Hospital Name GENERAL HOSPITAL JAYANAGAR

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