Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 KIRANBALA PALSANTOL,GABABASTA,
CUTTACK59 Y F BPL - 01.10.2019 10,000.00 100% 0 0
BOOT POP
CAST 10,000.00 NIL -
ADHAAR NO-8426
9636 7414-
2SAYAD SURAM
AGUDASH
DIALABARPUR,KENDR
APADA1M M BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-8234
5792 0573-
3LOPAMUDRA
SETHI
BANDHAMUNDA,BAL
ANGA,PURI2M F BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTIING 10,000.00 NIL - PIC NO-100 -
4ANUSHREE
DEVNATHMEDINIPUR,WB 7M F BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -7601
6197 2009-
5PRIYANSU
MOHARANA
BHAGABATPUR,TAN
GI,CUTTACK7M M BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-7169
6881 0565-
6UMA SANKAR
DALEIAGARPADA BHADRAK 12D M BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
236692449037-
7 MEETA SAHU
IMFA COLONY
CHOUDWAR,
CUTTACK
8D F BPL - 01.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
529096011384-
SWAMI VIVEKANAND NATIONAL INSTITUTE OF REHABILITATION TRAINING AND RESEARCHDepartment of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, Govt. of India
At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010
MINOR OT OPERATION REGISTER
PATIENT RECORD FOR THE MONTH OF OCTOBER- 2019 IN MINOR OT
1
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
8 DEBANSH SAHOOKALAMUHAN,SUBAR
NAPUR1M M BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
536762697526-
9 SK JAINABBRAMHANGADA,DHA
RMASALA,JAJPUR3M M BPL - 01.10.2019 10,000.00 100% 0 0
TENOTOMY &
SERIAL
CASTING
10,000.00 NIL -ADHAAR NO -
711492438811-
10 SATYASAI KARAJALESWARPUR,
BHADRAK,ODISHA8M M BPL - 01.10.2019 10,000.00 100% 0 0 PE-PLASTER 10,000.00 NIL -
ADHAAR NO -8520
5794 4066-
11 ANINDITA BHAKTAMATIAPADA,GHODA
BAZAR,PURI1M F BPL - 01.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO -
365537646544-
12 SANGITA MISHRABERHAMPUR,GANJA
M12D F BPL - 01.10.2019 10,000.00 100% 0 0 PE PLASTER 10,000.00 NIL -
ADHAAR NO -
940398122127-
13 MAMATA ROUT KANTEI,BELDA,WB 1.9Y F BPL - 01.10.2019 10,000.00 100% 0 0 WEDGING 10,000.00 NIL -ADHAAR NO -
858371150683-
14SRIMAYA
HARICHANDANBANGIDA,KHORDHA 2M M BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
440411024490-
2
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
15GOURAB KUMAR
NAYAK
BAIRAGPUR,PUDALA,
MAYURBHANJ1M M BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO
312363509964-
16SAGARIKA
PRIYADARSINI
POIBARI,DASPALA,NA
YAGARH,5M F BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
751992209465-
17PRIYANSU PRATIK
MOHAPATRA
PURBA
SASAN,PIPILI,PURI1M M BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
223995632913-
18PUSPANJALI
PRUSTI
TELIA,RAMBAG,JAJPU
R TOWN ,JAJPUR7M F BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO -
466104386038-
19 RAKESH DAS AGARPADA BHADRAK 1Y M BPL - 03.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO -
308062948885-
20ARNAB KUMAR
SAHOO
KANHEPUR,JAJPUR
ROAD,JAJPUR2.6Y M BPL - 03.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
430822410340-
3
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
21BIKRAMADITYA
MALLICK
SAKUNTALAPUR,
JAJPUR1Y M BPL - 03.10.2019 10,000.00 100% 0 0 A K POP CAST 10,000.00 NIL -
ADHAAR NO -
635737109361-
22 KANHA HATIOUKHANDA,BALIPAT
NA,KHORDHAN6Y M BPL - 03.10.2019 10,000.00 100% 0 0
WALKING&
POPCAST 10,000.00 NIL -
ADHAAR NO -
884690946738-
23 SRABAN BHOI
BISHARPUR,PRATAPR
UDRAPUR,BALIANTA,
KHORDHA
26Y M BPL - 03.10.2019 10,000.00 100% 0 0RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO -
282915658523-
24SUBASH CHANDRA
PANDA
BAULANIPATNA,SIM
ULIA BALESORE45Y M BPL - 03.10.2019 10,000.00 100% 0 0 ORIF(RT) 10,000.00 NIL -
ADHAAR NO -
649992013207-
25 SILU OJHA
NAHARKANTA,MANC
HESWAR,BBSR,KHOR
DHA
28Y M BPL - 04.10.2019 10,000.00 100% 0 0RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO -
677631540590-
26BHARAT CHANDRA
KUNDA
RAJKANIKA
,KENDRAPADA52Y M BPL - 04.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO -
882720441695-
4
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
27 BISWAJIT BHOITARABOI,BALIPATNA
KHORDHA3Y M BPL - 04.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO -
252163350794-
28GOVINDA
CHANDRA SAHOO
KURANG PRADHAN
RAIPUR,SADAR,CUTT
ACK
75 Y M BPL - 04.10.2019 10,000.00 100% 0 0BOOT& BAR
POP CAST 10,000.00 NIL -
ADHAAR NO -
593813264659-
29 SUMAN BIRASATKABAG,BISWANA
THPUR,KHORDHA6Y M BPL - 04.10.2019 10,000.00 100% 0 0
MANUPULATI
ON & U CAST 10,000.00 NIL -
ADHAAR NO -
224082593757-
30MURALIDHAR
BARIKBAGALPUR,CUTTACK 30 Y M BPL - 04.10.2019 10,000.00 100% 0 0 A K POP SLAB 10,000.00 NIL -
ADHAAR NO -
398776242587-
31KHETRAMOHAN
MALLICK
BAIROI,OLATPUR,CUT
TACK64 Y M BPL - 04.10.2019 10,000.00 100% 0 0
BOOT POP
CAST 10,000.00 NIL -
ADHAAR NO -
625018490687-
32 KANHA SETHFAKIMUNDA,PUATAR
AVA,SUBARNAPUR12 Y M BPL - 04.10.2019 10,000.00 100% 0 0
RE PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO -
768829696709-
5
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
33 MAMATA ROUT KANTEI,BELDA,WB 19 Y F BPL - 04.10.2019 10,000.00 100% 0 0
WEDGING&R
E PAIR POP
CAST
10,000.00 NIL -ADHAAR NO -
858371150683-
34JAGANNATH
SAHOO
TANDIKANA,URADHA
,GOVINDPUR,CTC36 Y M BPL - 04.10.2019 10,000.00 100% 0 0 B K POP SLAB 10,000.00 NIL -
ADHAAR NO -9486
17723159-
35 LATANJALI BHOIKURANG SASAN
SUNDARGRAM,CTC60 Y F BPL - 04.10.2019 10,000.00 100% 0 0 B E POP CAST 10,000.00 NIL -
ADHAAR NO -
229183256112-
36 TAHIRA BEGUMKALABAZAR,NUAPAT
NA,PURI11M F BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
614084609950-
37SHIBA SMITA
ROUTBALIAPAL,BALASORE 6 Y F BPL - 09-10-2019 10,000.00 100% 0 0 B.K POP SLAB 10,000.00 NIL -
ADHAAR NO - 6071
1611 8597-
38HEMA MALINI
PATRANAYAHATA PURI 22 Y F BPL - 09.10.2020 10,000.00 100% 0 0 B.K POP SLAB 10,000.00 NIL -
ADHAAR NO - 2405
0304 9181-
6
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
39 MAYRA KUJANGA,J.S PUR 2Y F BPL - 09.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -9449
9978 5121-
40 KANHA SETHIFAKIMUNDA,PUATAR
AVA,SUBARNAPUR12Y M BPL - 09.10.2019 10,000.00 100% 0 0
WEDGING RE-
PAIRING POP
CAST
10,000.00 NIL -ADHAAR NO -
768829696709-
41 SNEHANJALI JENAPALASINGA,PATAMU
NDAI,KENDAPADA17D F BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
971453301501-
42 PRIYANSA PATRAKANHEIPUR,KHALIKO
T,GANJAM7M F BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
284298220219-
43 B/O-SUJATA DALAIBAULABANDHA,BAN
PUR,KHORDHA1M M BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
639879650459-
44 JYOTSHNA LENKARAHAMBA,POSTAL,G
OVINDPUR,CTC15D F BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
256564920851-
7
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
45 KOUSHIK ADAKCHUDAMANI,BASUD
EBPUR,BHADRAK28Y M BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
609141435971-
46SURYAMANI
MALLICKATHILI,SONEPUR,CTC 3M M BPL - 09.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
552264924361-
47SULACHANA
BEHERA
DIUDIPUR,BADAPAD
A,KENDRAPADA1M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
515496169575-
48 SAMBIT PRADHANNIMIISULA,PALANGA,
GANJAM2M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
451813459487-
49KAMAL LOCHAN
BEHERA
KULIDA,BHOGRAI,BA
LESORE1M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
505700730630-
50RUDRA PRASAD
SAHOOPALASAHI,KHORDHA 11D M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
329317988623-
8
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
51 JHILI SAHOO HANDAPA,ANGUL 4M F BPL - 10.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
906829846386-
52 MD NIJAMKHADPOSH,CHAIBAS
A,JHARKHAND27D M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
612609391769-
53 DEBABRATA SETHIBANGARO,BARAPAD
A,KHALAKATA,PURI2M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
557222600289-
54 PRATYUS GOUDAKUSUPALI,BHANJA
NAGAR,GANJAM3M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
872456274575-
55LOPAMUDRA
SETHI
BANDHAMUNDA,BAL
ANGA,PURI2M F BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
950891320567-
56LOPAMUDRA
SETHI
BANDHAMUNDA,BAL
ANGA,PURI2M F BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
950891320567-
9
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
57SRIYANSHREE
SENAPATIBIDEIPUR,BHADRAK 14D F BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
950891320567-
58 DEBANSU DAS AGARPADA BHADRAK 1 M M BPL - 10.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
938936174469-
59KAMA LOCHAN
BEHERA
KULIDA,BHOGRAI,BA
LESORE11 M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5057
0073 0063-
60 SANGET MISHRABERHAMPUR,GANJA
M12 D F BPL - 10.10.2019 10,000.00 100% 0 0
TENOTOMY &
SERIAL
CASTING
10,000.00 NIL -ADHAAR NO - 9405
9812 2127-
61SUBHALA LAXMI
MOHANTY
KORKARA, NIALI
CUTTACK2 Y F BPL - 10.10.2019 10,000.00 100% 0 0
RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO - 2295
8457 6766-
62NITESH KUMAR
GAANBADAMBA CUTTACK 4 M M BPL - 10.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 2711
7042 4896-
10
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
63 BINA SINGHBARIPADA
MAYURBHANJ15 Y F BPL - 10.10.2019 10,000.00 100% 0 0 B K CAST 10,000.00 NIL -
ADHAAR NO - 8864
7977 4734-
64 AKUL BEHERATERHAI,
KENDRAPADA62 Y M BPL - 10.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -
ADHAAR NO - 3554
7477 6466-
65 MUSKAN GOPE
RAILWAY COLONY
ROURKELA
SUNDERGARH
1 Y F BPL - 10.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -ADHAAR NO - 5617
826 12071-
66PRABHU PRASAD
NATH
GOBINDPUR
DHENKANAL1 Y M BPL - 11.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 8680
8890 0735-
67 SINDHU OJHA
NAHARKANTA,MANC
HESWAR,BBSR,KHOR
DHA
28 Y M BPL - 11.10.2019 10,000.00 100% 0 0RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO - 6776
3154 0590-
68 BISWAJIT BHOITARABOI,BALIPATNA
KHORDHA3 Y M BPL - 11.10.2019 10,000.00 100% 0 0
RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO - 2521
6335 0794-
11
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
69 RUPESH BAGARTINARASINIGHPUR
SARGADI NUAPADA15 D M BPL - 11.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5662
0718 0975-
70 SRABANI KHATUA TIGIRIA CUTTACK 1 Y F BPL - 11.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
85989 4657 1677-
71DIBYA RANJAN
KATAKENDRAPADA 2 Y M BPL - 11.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5227
9754 0209-
72 KHOJINI SETHI BADAGADA GANJAM 7 Y M BPL - 14.10.2019 10,000.00 100% 0 0RE PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO - 5323
3351 9343-
73 SOURAV DEHURIPATRAJHADA
BALASORE1 M M M - 14.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5598
2922 9168 -
74TANUSHREE
NAYAKBALASORE 2 D F BPL - 14.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO - 4973
3991 6888-
12
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
75 ARCHANA SAHOO ATHAGADA CUTTACK 1 Y F BPL - 14.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO -3634
3805 7017-
76BHARAT CHANDRA
KUNDA
RAJKANIKA
,KENDRAPADA52 Y M BPL - 14.10.2019 10,000.00 100% 0 0
RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO -8827
8044 1695-
77ANANTA
CHARANA
MARANDI
KAPTIPADA
MAYURBHANJ1 Y M BPL - 14.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -6288
2668 9635-
78 MAMATA ROUT KANTEI,BELDA,WB 19 Y M BPL - 14.10.2019 10,000.00 100% 0 0RE PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO -9352
7583 3658-
79 DEBANSH SAHOOKAMALA LOCHAN
SUBARNAPUR1 M M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5367
6269 7526-
80SAYAD SURAM
AGUDASHKENDRAPADA 1 M M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 8234
5792 0573-
13
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
81ANUSHREE
DEVNATH
MOHANPUR,
MEDINAPUR,WB7 M F BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 7601
6197 2009-
82 POITI MOHANTY TIHIDI BHADRAK 1 M F BPL - 15.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 8366
3503 6085-
83 HARDIK SABAR BHELA NUAPADA 1 M M BPL - 15.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 9156
29994 3078-
84PRADEEPTA
KUMAR NANDA
PRATAPRUDRAPUR,
BALIPATNA,
KHURDHA
52 M BPL - 15.10.2019 10,000.00 100% 0 0RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO -
635485778599-
85PRIIYANSHU
MOHAPATRATANGI CUTTACK 7Y M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 7169
68810 5655-
86 NILIMA DUTTA MAYURBHANJ 9 M M BPL - 15.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL - ADHAAR NO - -
14
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
87 ALLIA BEHERA DHENKANAL 4 M F BPL - 15.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 9639
3130 5151-
88SHRIYA
HARICHANDANKHURDA 2 M M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 4404
1102 4490-
89 MEETA SAHUCHOUDWAR,
CUTTACK8 D F BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 5290
9601 1384-
90RITISH ROSHAN
MOHARANA
CHAMPUR,
CHHATIA,JAJPUR1 M M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 7232
5964 6296-
91UMA SHANKAR
DALAIAGARPADA BHADRAK 12 D M BPL - 15.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 2366
9244 9037-
92 TRISH RANA BALANGIR 11 Y M BPL - 15.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 9017
4446 5493-
15
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
93 MD SARTHAKKENDRAPADA,ODISH
A23 D M BPL - 16.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO - 6745
0095 4700-
94 SATYAJIT NAYAK JATANI KHORDHA 10D M BPL - 16.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 3166
3899 3704-
95GOURAV KUMAR
NAYAK
MAYURBHANJ,ODISH
A3 M M BPL - 16.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO - 3123
6350 9964-
96PUSPANJALI
PRUSTITALIA,JAJPUR 7 D F BPL - 16.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 4661
0438 6036-
97 SANCHALI JENAPALSINGH,KENDRAP
ADA17 D F BPL - 16.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 9714
53301501-
98 JYOSTNA LENKA RAHAMBA,CUTTACK 15 D M BPL - 16.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 2565
6492 0859-
16
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
99 SONALI PARIDA KRUSHNAPUR BANKI 12 Y F BPL - 16.10.2019 10,000.00 100% 0 0 A.E CAST 10,000.00 NIL -ADHAAR NO - 5878
5797 7121-
100 KANHA HATIBALIPATANA
KHORDHA6 Y M BPL - 16.10.2019 10,000.00 100% 0 0 WEDGING 10,000.00 NIL -
ADHAAR NO - 8846
9094 6738-
101 KANHA SETH TARBHA,SONEPUR 12 Y M BPL - 16.10.2019 10,000.00 100% 0 0 A.K CAST 10,000.00 NIL -ADHAAR NO - 7688
2969 6709-
102 INDRAJIT BEHERA SORA,BALASORE 14 Y M BPL - 16.10.2019 10,000.00 100% 0 0CYLINDER
CAST 10,000.00 NIL -
ADHAAR NO - 5331
7672 3572-
103 AJAY DASNUAGAON
,JAGATSINGHPUR31Y M BPL - 17.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO -
379438382271-
104SAGARIKA
PRIYADARSINI
POIBARI,DASPALA,NA
YAGARH,3M F BPL - 17.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO -
757992209465-
17
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
105 PITABAS LENKANUAGAON,KONARK,
PURI55Y M BPL - 17.10.2019 10,000.00 100% 0 0
RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO - 4458
68748901-
106 RAKESH DASAGARPADA,
BHADRAK1Y M BPL - 17.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
308062948885-
107JAGYASENI
KAYASTA
DASARATHPUR,MAN
GALPUR,JAJPUR5Y F BPL - 17.10.2019 10,000.00 100% 0 0 A K POP CAST 10,000.00 NIL -
ADHAAR NO-
429313942446-
108SARAT CHANDRA
TRIPATHYKAKATPUR,PURI 42Y M BPL - 17.10.2019 10,000.00 100% 0 0
RE -FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
441761554440-
109 JAGESWAR MAJHI
HANDIGUDA,TENTOI,
CHHENDIPADA,ANGU
L
13Y M BPL - 17.10.2019 10,000.00 100% 0 0 A E POP CAST 10,000.00 NIL -ADHAAR NO-
369564311818-
110 SURYAKANTA DASBRAMHANBATI,NALI
BAR,JAGATSINGHPUR2Y M BPL - 17.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -
ADHAAR NO-
505252130715-
18
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
111 EHSANULA KHAN NAHARPUR,JAJPUR 18Y M BPL - 18.10.2019 10,000.00 100% 0 0 A K POP CAST 10,000.00 NIL -ADHAAR NO-
954940170106-
112 MAMATA ROUT KANTEI,BELDA,WB 19 Y F BPL - 18-10-2019 10,000.00 100% 0 0
WEDGING
AND RE POP
CAST
10,000.00 NIL -ADHAAR NO - 9352
7583 3658-
113 GANGA BEHERANAGARA,KAKATPUR,
PURI28Y M BPL - 18.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
964196079083-
114 ANISHA SETHY SUBARNAPUR 14Y F BPL - 18.10.2019 10,000.00 100% 0 0 A K POP CAST 10,000.00 NIL -ADHAAR NO-
607393882951-
115JEEVA JYOTI
PANDAERUM,BHADRAK 5M M BPL - 18.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
968433543201-
116 BISWAJIT BHOI TARABOI, KHORDHA 3Y M BPL - 18.10.2019 10,000.00 100% 0 0RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
252163350794-
19
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
117 ARAB NAYAKNUAGAONBBSR,
KHORDHA,2Y M BPL - 18.10.2019 10,000.00 100% 0 0 A E POP CAST 10,000.00 NIL -
ADHAAR NO-
233861671254-
118 SUSAMA PADHIARI ASTARANGA,PURI 46Y F BPL - 18.10.2019 10,000.00 100% 0 0BIVALED A E
POP SLAB 10,000.00 NIL -
ADHAAR NO-
582047161053-
119 SURYAKANTA DAS JAGATSINGHPUR 2Y M BPL - 18.10.2019 10,000.00 100% 0 0 A E POP CAST 10,000.00 NIL -ADHAAR NO-
505252130715-
120 AKULI BEHERATERHAI,
KENDRAPADA62Y M BPL - 18.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -
ADHAAR NO-
355474776466-
121 SOURAV DAS OLATPUR,CTC 10Y M BPL - 21.10.2019 10,000.00 100% 0 0RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
716760919407-
122 PRATIK MARTHA ANUGUL 48Y M BPL - 21.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
733572860391-
20
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
123 RITESH SAMINI JARING,BARGARH 24D M BPL - 21.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
270359681796-
124B/O - ASMA
BEGUM
OLIPADA,JAGATSING
HPUR6 D M BPL - 21-10-2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 8213
0211 5751-
125 JOGESWAR MAJHI
HANDIGUDA,TENTOI,
CHHENDIPADA,ANGU
L
13 Y M BPL 21.10.2020 10,000.00 100% 0 0A.E POP
PSLAB 10,000.00 NIL -
ADHAAR NO - 3645
6431 1818-
126 SOM MAHANTAMADHAGADA,
KEONJHAR1 Y M BPL - 22-10-2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO - 3761
2270 1954-
127 ABHISEK SAHOOJHARMUNDA,KALAH
ANDI2M M BPL - 21.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
515783194111-
128RUDRA PRASAD
SAHOOPALASI KHORDHA 11M M BPL - 21.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
329317988623-
21
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
129 ASUTOSH BEHERA SAHOOPADA,PURI 24D M BPL - 21.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
699705168876-
130 TUSHAR SAHUBHATAPADA,BALANG
IR1.1Y M BPL - 21.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
765665450737-
131 SAI KRISHNA JAYPUR,DHENKANAL 1M M BPL - 21.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
293042315513-
132 ARJUN PRADHANDIGHI,SITHALO,CUTT
ACK1M M BPL - 21.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -
ADHAAR NO-
735014230418-
133PRABHU PRASAD
ROUT
PAHANGA,DEULI,CUT
TACK2M M BPL - 22.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
815692196345-
134PRADIPTA KUMAR
NANDABALIANTA,KHORDHA 52 M BPL - 22.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
365485778599-
22
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
135 SAURAV DEHURIKUSUDIHA,BALESWA
R1M M BPL - 22.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
559829229168-
136 ARCHANA SAMAL ATHAGADA CUTTACK 1Y F BPL - 22.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
363438057017-
137 PIYUSH JENAPARJANG,DHENKANA
L2Y M BPL - 22.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
506131987912-
138 JEET MALLICK HALDIPADA,JAJPUR 11M M BPL - 22.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
679138761024-
139 MAYRA KUJANGA,J.S PUR 1M F BPL - 22.10.2019 10,000.00 100% 0 0
TENOTOMY &
SERIAL
CASTING
10,000.00 NIL -ADHAAR NO-
244999785121-
140 BIKASH NAYAKHARISANKARPUR,PU
RI5Y M BPL - 22.10.2019 10,000.00 100% 0 0
RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
593510640089-
23
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
141 ARADHYA BISWALNILAKANTHAPUR,JAJ
PUR5Y F BPL - 22.10.2019 10,000.00 100% 0 0
HIP SPICA
REPAIR 10,000.00 NIL -
ADHAAR NO-
839132199933-
142 PRIYABATI NAGMANAMUNDA,BOUD
H12Y F BPL - 22.10.2019 10,000.00 100% 0 0
RE PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
325607324597-
143 SATYAJIT NAYAK JATANI KHORDHA 10D M BPL - 23.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
316638993704-
144PRABHU PRASAD
NATH
GOBINDPUR
DHENKANAL1M M BPL - 23.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
878088900735-
145 SNEHANJALI JENAPATAMUNDAI,KENDR
APADA17M F BPL - 23.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
971453301501-
146PUSPANJALI
PRUSTITOWN ,JAJPUR 1M F BPL - 23.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
466104386036-
24
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
147 PRITAM SINGH BALIANTA,KHORDHA 7Y M BPL - 23.10.2019 10,000.00 100% 0 0 A E POP CAST 10,000.00 NIL -ADHAAR NO-
969965001640-
148 KOUSHIK ADAKBASUDEBPUR,BHADR
AK2M M BPL - 23.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
609141435971-
149 SRABANI KHATUA TIGIRIA CUTTACK 1D F BPL - 23.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
858946571677-
150SURYAMANI
MALLICKSONEPUR,CUTTACK 3M M BPL - 23.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
552264924361-
151 MAMATA ROUT KANTEI,BELDA,WB 19Y F BPL - 23.10.2019 10,000.00 100% 0 0 A K POP
CAST 10,000.00 NIL -
ADHAAR NO-
935275833658-
152 PRITI MOHANTY TIHIDI BHADRAK 1Y F BPL - 24.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
833635036085-
25
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
153KAMAL LOCHAN
BEHERA
KULIDA,BHOGRAI,BA
LESORE2Y M BPL - 24.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
505700730630-
154LOPAMUDRA
SETHIBALANGA,PURI 2Y F BPL - 24.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
980891320867-
155 SANJIT PRADHAN GANJAM 2M M BPL - 24.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
451813459487-
156 DEBANSU DASAGARPADA,
BHADRAK4Y M BPL - 24.10.2019 10,000.00 100% 0 0
SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
938936174469-
157 GANGA BEHERANAGARA,KAKATPUR,
PURI2M M BPL - 24.10.2019 10,000.00 100% 0 0
FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
964196079083-
158 RUPESH BAGARTI SARGADI,NUAPADA 2M M BPL - 24.10.2019 10,000.00 100% 0 0
TENOTOMY &
SERIAL
CASTING
10,000.00 NIL -ADHAAR NO-
566209180975-
26
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
159MANORANJAN
MISHRAGONDIA,DHENKANAL 43Y M BPL - 24.10.2019 10,000.00 100% 0 0 U SLAB 10,000.00 NIL -
ADHAAR NO-
330230852271-
160 JHILI SAHOO HANDIGUDA,ANGUL 4M F BPL - 25.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
906829846388-
161DHANESWAR
ROUTNIALI,CUTTACK 35Y M BPL - 25.10.2019 10,000.00 100% 0 0
RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
541545479002-
162 SUDAM PRADHAN NUAGADA,PURI 22Y M BPL - 25.10.2019 10,000.00 100% 0 0 B E POP CAST 10,000.00 NIL -ADHAAR NO-
905100362801-
163 CHINTU NAYAK KUNDA,DHENKANAL 9Y M BPL - 25.10.2019 10,000.00 100% 0 0 B K POP CAST 10,000.00 NIL -ADHAAR NO-
970528449992-
164 JULI BARIKBALRAM
PRASAD,ANGUL7D F BPL - 25.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
340366466876-
27
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
165 SUSAMA PADHIARI ASTARANGA,PURI 46Y F BPL - 25.10.2019 10,000.00 100% 0 0 A E POP SLAB 10,000.00 NIL -ADHAAR NO-
582047161053-
166 RITESH SAMINI BARGARH 24D M BPL - 28.10.2019 10,000.00 100% 0 0SERIAL POP
CAST 10,000.00 NIL -
ADHAAR NO-
270354681796-
167SUNDARI
PRADHANGOP,PURI 7OY F BPL - 28.10.2019 10,000.00 100% 0 0
RE FIG 8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
887479911235-
168RITISH ROSHAN
MOHARANACHHATIA,JAJPUR 1M M BPL - 28.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
723256946296-
169 DURJA ROUT KASARDA,CUTTACK 38Y M BPL - 28.10.2019 10,000.00 100% 0 0FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
584888831617-
170 SAI KRISHNAJAYAPUR,DHENKANA
L1M M BPL - 28.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
293042315513-
28
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
171 TANMESA GOUDA SIHALA,GANJAM 2Y F BPL - 28.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
527620317437-
172SRIMAYA
HARICHANDANKHORDHA 25Y M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
440411024490-
173 DEBANSU SAHOO SUBARNAPUR 2M M BPL - 29.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
536762697526-
174 ANUSKA ROUT ADASPUR,CUTTACK 11M F BPL - 29.10.2019 10,000.00 100% 0 0RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
267258260261-
175 PRATYUS GOUDA KUSUPALI,GANJAM 3M M BPL - 29.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
572456274575-
176 ABHISEK SAHOOJHARMUNDA,KALAH
ANDI2M M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
515783194111-
29
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
177 PRATIK MARTHA ANUGUL 16D M BPL - 29.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
733572860391-
178PRABHU PRASAD
ROUTDEULI,NIALI,CUTTACK 2M M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
815692196345-
179ASHUTOSH
BEHERASAHOOPADA,PURI 24D M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
699705168876-
180UMA SHANKAR
DALAI
AGARPADA,
BHADRAK12D M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
236692449037-
181SAYAD SURAM
AGUDASH
KENDRAPADA,ODISH
A1M M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-8234
5792 0573-
182ANUSHREE
DEVNATH
PASCHIM
MEDINIPUR,WB6M F BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
760161972009-
30
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
183 DEBABRATA SETHI BANGARO,PURI 2M M BPL - 29.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
557222600289-
184 SUDHANSU SETHITIRTOL,JAGATSINGHP
UR1M M BPL - 29.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
889536760964-
185 SHIBASMITA ROUT BALIAPAL,BALESWAR 6Y F BPL - 29.10.2019 10,000.00 100% 0 0 B K POP SLAB 10,000.00 NIL -ADHAAR NO-
607116118597-
186ABDUL REHMAN
MANDAL
MANCHESWAR,KHOR
DHA65Y M BPL - 29.10.2019 10,000.00 100% 0 0
RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
875605374471-
187 CHINTU NAYAK KUNDA,DHENKANAL 9Y M BPL - 29.10.2019 10,000.00 100% 0 0RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
970528449992-
188 MD SARTHAK GOPEI,KENDRAPADA 23D M BPL - 30.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
674500954700-
31
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
189 SATYAJIT NAYAK JATANI KHORDHA 10M M BPL - 30.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
316638993704-
190 JYOSTNA LENKA RAHAMBA,CUTTACK 15D F BPL - 30.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
266564920851-
191 HARDIK SABAR BHELA NUAPADA 1M M BPL - 30.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
915629943078-
192SRIYANSHREE
SENAPATIBIDEIPUR,BHADRAK 14D M BPL - 30.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
984616057718-
193NIRMAL
MOHANTYBALIANTA,KHORDHA 7Y M BPL - 30.10.2019 10,000.00 100% 0 0 A E POP CAST 10,000.00 NIL -
ADHAAR NO-
560279885705-
194PRADIPTA KUMAR
NANDABALIANTA,KHORDHA 52Y M BPL - 30.10.2019 10,000.00 100% 0 0
RE -FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
365485778599-
32
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
195PADMANAVA
NATHA
DERABISH,KENDRAPA
DA2M M BPL - 30.10.2019 10,000.00 100% 0 0
TENOTOMY &
SERIAL
CASTING
10,000.00 NIL -ADHAAR NO-
419269162824-
196 KRISHNA MANIKBARUAN,DHENKANA
L5Y M BPL - 30.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
761531474075-
197RISHI KRISHNA
SAMAL
GOVINDPRASAD,DHE
NKANAL18D M BPL - 30.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
406739922017-
198 YASBANT BARIKBIRIDI,JAGATSINGHP
UR,24Y M BPL - 30.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
672587757643-
199 EHSANULA KHAN NAHARPUR,JAJPUR 18Y M BPL - 30.10.2019 10,000.00 100% 0 0PTB POP
CAST 10,000.00 NIL -
ADHAAR NO-
954940170106-
200 SATWIK NAYAK BALANGA,PURI 1Y M BPL - 31.10.2019 10,000.00 100% 0 0RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
338448612845-
33
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
201SIBASANKAR
PRADHAN
CHAIBASA,JHARKHAN
D2Y M BPL - 31.10.2019 10,000.00 100% 0 0
RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
685712104599-
202SULACHANA
BEHERA
PATAMUNDAI,KENDR
APADA34Y F BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
515496169575-
203 JULLI BARIKBALARAM
PRASAD,ANUGUL7M F BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
340366466876-
204SAGARIKA
PRIYADARSINIDASPALA,NAYAGARH 5M F BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
757992209465-
205 SNEHANJALI JENAPALASINGA,KENDRAP
ADA17M F BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
971453301501-
206 AJAYA DASNUAGAON,JAGATSIN
GHPUR31Y M BPL - 31.10.2019 10,000.00 100% 0 0
RE-FIG-8
BANDAGE 10,000.00 NIL -
ADHAAR NO-
379438382271-
34
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
207 RAJASHREE JENA JENAPUR,JAJPUR 14D F BPL - 31.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
799064768020-
208 MD NIJAMKHADPOSH,JHARKHA
ND27D M BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
612609391769-
209JIVAN JYOTI
PANDAERUM,BHADRAK 5M M BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
968433543201-
210 SUJATA DALAI BANAPUR,KHORDHA 3M F BPL - 31.10.2019 10,000.00 100% 0 0SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
639879650459-
211 RAKESH DASAGARPADA,
BHADRAK1Y M BPL - 31.10.2019 10,000.00 100% 0 0
SERIAL
CASTING 10,000.00 NIL -
ADHAAR NO-
308062948885-
212 MAMATA ROUT KANTEI,BELDA,WB 19Y F BPL - 31.10.2019 10,000.00 100% 0 0RE-PAIR POP
CAST 10,000.00 NIL -
ADHAAR NO-
935275833658-
35
Sl.
NO.
Name of
beneficiary
Complete Address Age Sex Inocme Type
of Aid
Given
Date on which
given
Total cost of aid
including fabri-
cation/ fitment
charges
Subsidy
provided
Tavel
cost
paid to
out-
station
bene-
ficiary
Boarding
and
lodging
expenses
paid
Whether any
surgical
correction under-
taken
Total
10+11+12+13
No. of
days for
which
stayed
Whether
accom-
panied by
escort
Ration Card No./
Voter ID No./
Aadhar Card No.
Photo of bene-
ficiary Yes/NoContact
No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
21,20,000.00 21,20,000.00 TOTAL..
36