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Application

The document is a registration acknowledgment for a person with a disability, Manoranjan Swain, with an enrollment number and date of registration. It includes personal details, contact information, and disability specifics, indicating a locomotor disability with a 65% disability percentage due to an accident. The document also provides information about the issuing authority and the hospital where treatment was received.

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santosh
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23 views2 pages

Application

The document is a registration acknowledgment for a person with a disability, Manoranjan Swain, with an enrollment number and date of registration. It includes personal details, contact information, and disability specifics, indicating a locomotor disability with a 65% disability percentage due to an accident. The document also provides information about the issuing authority and the hospital where treatment was received.

Uploaded by

santosh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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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: 213480000025050004861 Enrolment Date: 09/05/2025

PERSONAL DETAILS

Full Name in Regional


Name of Applicant Manoranjan Swain ମେରଂଜନ ସ୍ୱାଇ |
Language
Applicant Father's Name Netramani Swain Applicant Mother's Name
Date of Birth 01/01/1971
Mobile Number 9937207610 E-Mail Id
Gender Male Category
Relation with PwD
Blood Group Father
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Netramani Swain Caretaker / Attendant / 9937207610
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. ********4590

Address of Correspondence

Address At/po-alabaga Ps-


basudevpur,Alabaga
Basudebpur Bhadrak
Odisha 756124
Nature of Document Aadhaar card
for Address Proof

DISABILITY DETAILS

Do you have disability certificate? Yes Disability Type Locomotor Disability


Disability certificate uploaded? Yes Sr. No. / Registration No. of Certificate 21041523336
Date of Issuance of Certificate 01/06/2015 Details of Issuing Authority Medical Authority
Disability Percentage 65
Disability Due To Accident
Hospital Treating State / UTs Odisha Hospital Treating District Bhadrak
Hospital Name District Headquarter Hospital, Bhadrak

For more information please scan the QR code to


visit 'PwD Login'
This is computer generated receipt and does not require any signature.

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