Registration Form Gender: MaleFemaleOther Category: GeneralOBCSCST Blood Group: O+O-A+A-B+B-AB+AB- Marital Status: MarriedUnmarriedWidowDivorced Relation with Person with Disability : FatherMotherWifeHusbandOther Educational Details: PrimaryMiddle/Higher PrimarySenior SecondaryHigher SecondaryDiplomaGraduatePG DiplomaPost GraduateOther Primary Criteria for Registration : 1. Development Delay2. Physical Disability/Chronic Illness3. Learning Disability4. Visually Impaired5. Hearing Impaired6. Speech/Language Difficulties7. Behavioral/Emotional Difficulties8. Communication/Socialization Difficulties9. Autistic Spectrum Disorder10. Other (please specify Person’s Disability Certificate: YesNo Address Details: Δ