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Department of Empowerment of Persons with Disabilities,
Ministry of SocialJustice and Empowerment, Government of Indra
Disability Certificate
[s$uing Medical Authority, Rajkot, Gujarat
Certificate No.: GJ0920219730021003 Date:
This is to certify that l/We have carefully examined Shri Dineshkumar Bhanushankar Pandya Son of Shri
Bhanushankar Date of Birth 08/1U1973 Age 44 Year(s) Male, Registration No.2409/0OOOOft7LuOs7lOLB
resident of House No. Mansatirth-2,wing-a,block No,307,, 3rd Floor, Opp. Swami Narayan Gurukul, Rajkot -
350002 Sub District Rajkot District Rajkot State / UTs Gujarat
Whose photograph is affixed above, and l/We satisfied that:
(A) He is a case of Blinoness
(B) The diagnosis in his case is BE - Total Retinal detachment with RE - K. Opacity
(C) He has 100%(in figure) One hundred percent(in words) Permanent in relation to his (part of body) as per
guidelines (to be specified),
The applicant have been submitted the following document(s) as proof of residence
Nature of Document(s): Other (Domicile Certificate)
Signature / Thumb impression of the Person With Disability
Signatory o[ notified Medical Authority Member
lssuing Medical Authority, Rajkot, Gujarat
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This Card/Certificate is meaflt to,qerWy;the disability of the person and is not an instrument for lD/Address proof for any
pur00se.
17. T
FO& ADD SHOP PROMOTIONS PRIVATE
As Per Our R€port Of Even Date
c, s. GAJERA & CO,
Chdrteftd Actuunknts
Place
Date
Rajkot
06/04/2018
CHETAN S GAJERA
Ptupneb/
Mem.No.:127370
FRN No.: 128504W
Last year turn over of Dinesh Pandya Company
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