Registration - Unified Portal

Member Registration

Please enter your details exactly as per your Aadhaar card.

Personal Details

Aadhaar Number *

First Name (Given) *

Middle Name

Last Name (Surname) *

Gender *

Date of Birth *

Age

Mobile Number *

Email Address

Marital Status *

Family Details

Father First Name *

Father Middle Name

Father Last Name *

Is Father Divyang?

Mother First Name *

Mother Middle Name

Mother Last Name *

Is Mother Divyang?

Status Details

Caste Category *

Domicile of Maharashtra *

PAN Number

Divyang Status *

UDID Number *

Disability Name *

Nature of Disablity *

Disability Percentage (%) *

Current Address

House No / Building *

Street Name

Pincode *

District *

Sub District *

Village / Ward *

Local Body

Permanent Address

Same as Current Address?

House No / Building

Street Name

Pincode

District

Sub District

Village / Ward

Local Body

Other Details

Confirm: Do you have a Legal/Limited Guardian available other than Parent?

Education Level *

Highest Qualification

Nature of Main Occupation

Main Occupation

Average Annual Income

Parents Combined Income

Whether BPL

Whether EWS

Bank Account Details

Bank Account Number

IFSC Code

Bank Name

Account Holder Name

Caretaker Details

First Name *

Middle Name

Last Name *

Mobile Number *

Relationship *

Is this an Institutional Caretaker? (NGO/Hostel)

Caretaker Address

House No / Building *

Street Name

Pincode *

District *

Sub District *

Village / Ward *

Local Body

Member Registration

Personal Details

Family Details

Spouse Details

Status Details

Current Address

Permanent Address

Other Details

Bank Account Details

Caretaker Details

Institution Details

Caretaker Address

Locomotor Disability
Leprosy Cured Persons
Cerebral Palsy
Dwarfism
Muscular Dystrophy
Acid Attack Victim
Blindness
Low Vision
Deaf
Hard of Hearing
Speech and Language Disability
Intellectual Disability
Specific Learning Disability
Autism
Mental Illness
Multiple Sclerosis
Parkinson's Disease
Haemophilia
Thalassemia
Sickle Cell Disease
Multiple Disabilities