Disability Certificate
Jalpaiguri Government Medical College & Hospital
Hospital Road, P.O. Dinbazar, P.S. Kotwali
Jalpaiguri, West Bengal, 735101
Certificate/UDID No. WB3130219970010879
Date of Issue: 29/01/2025
This is to certify that I/we have carefully examined
Rupali Roy Date of Birth
03/05/1997,
Gender
Female, Registration No.
1931/40000/0250/1006135, Resident of
Vill - Uttarkathimari,
P.O - Dakshin Khutimari, P.S - Dhupguri, Jalpaiguri,
West Bengal - 735210 whose photograph is affixed above,
and I am/we are satisfied that:
(A)
She is a case of:
Blindness
(B) Name of affected body part:
Both Eye
(C) The diagnosis in her case is
visual impairment
(D)
She has
100% (in figure)
one hundred percent (in words) disability and the nature of certificate is
Permanent as per the guidelines for the purpose of assessing the extent of specified disability in a person
included under the Rights of Persons with Disabilities Act, 2016 notified by Government of India vide
S.O.1338(E) dated
12/03/2024.
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Signature / Thumb impression of the Person with
Disability:
Signature of notified Medical Authority Members:
