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: 213460000025010100398 Enrolment Date: 30/01/2025
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Trilochan Mahalik ତ୍ରିେଚନ ମହାଳିକ
Language
Applicant Father's Name Shachindra Mahalik Applicant Mother's Name
Date of Birth 26/07/1969
Mobile Number 9348076027 E-Mail Id trilochanm2607@gmail.com
Gender Male Category
Relation with PwD
Blood Group Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Shachindra Mahalik Caretaker / Attendant / 6370654861
Related Related
Optional Details
Personal Income (Annual) 0 Highest Qualification
Employed or Unemployed
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********4949
Address of Correspondence
Address At-hatiadiha Po-hatiadiha,
Baleshwar Sadar Baleshwar
Odisha 756028
Nature of Document Aadhaar card
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? No Disability Type Locomotor Disability
Disability Due To Diseases
Hospital Treating State / UTs Odisha Hospital Treating District Baleshwar
Hospital Name District Headquarter Hospital, Baleswar
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visit 'PwD Login'
This is computer generated receipt and does not require any signature.
