at- olatpur , p.o- bairoi , dist- cuttack (odisha ), pin - 754010...

13
Sl. NO. Name of beneficiary Complete Address Age Male/ Femal e Incom e Type of Aid Give n Date on which given Total cost of aid including fabri-cation/ fitment charges Subsi dy provid ed Tavel cost paid to out- stati Boarding and lodging expenses paid Whether any surgical correction under-taken Total 10+11+12+13 No. of days for which stayed Wheth er accom- panied by escort Aadhar Card No. Photo of bene- ficiary any Mobile No. or land line number with STD Code** 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 1 RINKU PUJARI C/O JAGAMOHAN PUJARI AT KULER PS JAIPATNA DIST KALAHANDI 1Y M BPL - 04.02.2020 10,000.00 100% - - BIL. PMSTR 10,000.00 Nil Nil Adhar No Collected X 2 TARANGIRI NAG C/O DAMBARUDHAR NAG AT CHIKILI PS JUNAGARH DIST KALAHANDI 1Y F BPL - 04.02.2020 10,000.00 100% - - BIL. TA LENGTHERI NG 10,000.00 Nil Nil Adhar No Collected X 3 DAMBARU DHAYADA MAJHI C/O DAYA CH. MAJHI AT CHHATAPADA PS JAIPATNA DIST KALAHANDI 1Y M BPL - 04.02.2020 10,000.00 100% - - BIL. PMSTR 10,000.00 Nil Nil Adhar No Collected X 4 YASH MEHER C/O GIRIDHARI MEHER AT KHALIAKARI PS GOLAMUNDA DIST KALAHANDI 3Y M BPL - 04.02.2020 10,000.00 100% - - RT. MPSTR 10,000.00 Nil Nil Adhar No Collected X SURGICAL CAMP SWAMI VIVEKANAND NATIONAL INSTITUTE OF REHABILITATION TRAINING AND RESEARCH Department 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 SURGERY CAMP AT KALAHANDI DISTRICT ON 04.02.2020 UNDER ADIP SCHEME (A) 1

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Page 1: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1RINKU

PUJARI

C/O

JAGAMOHAN

PUJARI AT

KULER PS

JAIPATNA DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

2TARANGIRI

NAG

C/O

DAMBARUDHAR

NAG AT CHIKILI

PS JUNAGARH

DIST

KALAHANDI

1Y F BPL -

04

.02

.20

20

10,000.00 100% - -

BIL. TA

LENGTHERI

NG

10,000.00 Nil NilAdhar No

Collected

X

3

DAMBARU

DHAYADA

MAJHI

C/O DAYA CH.

MAJHI AT

CHHATAPADA

PS JAIPATNA

DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

4 YASH MEHER

C/O GIRIDHARI

MEHER AT

KHALIAKARI PS

GOLAMUNDA

DIST

KALAHANDI

3Y M BPL -

04

.02

.20

20

10,000.00 100% - - RT. MPSTR 10,000.00 Nil NilAdhar No

Collected

X

SURGICAL CAMP

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

SURGERY CAMP AT KALAHANDI DISTRICT ON 04.02.2020 UNDER ADIP SCHEME (A)

1

Page 2: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

5JOSABANTI

MAJHI

C/O SITARAM

MAJHI AT

CHANDPUR PS

JAIPALAM DIST

KALAHANDI 1Y F BPL -

04

.02

.20

20

10,000.00 100% - - RT. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

6 PINTU MAJHI

C/O DASARA MAJHI

AT SUNKHADIHA

DIST KALAHANDI

9M M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

7 NEHA SA

C/O

MUKTESWAR AT

BARDHAGAM

DIST

KALAHANDI 4Y F BPL -

04

.02

.20

20

10,000.00 100% - - RT. MPSTR 10,000.00 Nil NilAdhar No

Collected

X

8KISHORE

NAIK C/O RAGHU

NAIK AT TEMRA

DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

9CHANDAN

MAJHI

C/O SHANKAR

MAJHI AT

GAMBHARIGUD

A DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - RT. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

2

Page 3: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

10

SHIBANAND

A

DANDSENA

C/O BHIKARI

DANDSENA AT

CHINGUDISAR

PS JURAGARH

DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

11MAHI

BANUA

C/O AKHAYA

BNUA AT

BHAIRIGUDA PS

JURAARH DIST

KALAHANDI3Y F BPL -

04

.02

.20

20

10,000.00 100% - -

BIL.

PLASTER

AND

LENGETHINI

G

10,000.00 Nil NilAdhar No

Collected

X

12MUNA

MAJHI

C/O CHITRASEN

MAJHI AT

DHAMNPUR PO

BORGUMA PS

GOLAMUNDA

DIST

KALAHANDI

1Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

13ADYASA

SAHU

C/O GHASIRAM

SAHU AT

DANGARMAL

DIST

KALAHANDI 5Y F BPL -

04

.02

.20

20

10,000.00 100% - -

RT. PLASTER

AND TA

LENGTHENI

NG

10,000.00 Nil NilAdhar No

Collected

X

14

GUNJAN

DHANGADA

MAJHIC/O SANKAR

MAJHI AT

SUNAMAL

KALAHANDI

8Y F BPL -

04

.02

.20

20

10,000.00 100% - - LT. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

3

Page 4: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

15 AKASH NAG

C/O NIRANJAN

NAG AT

BISWARATIN

DIST

KALAHANDI 10Y M BPL -

04

.02

.20

20

10,000.00 100% - - RT. PMSTR 10,000.00 Nil NilAdhar No

Collected

X

16

KRISHNA

MAHANAND

A

C/O ROHIT

MAHANANDA

AT

BAHADURPITA

DIST

KALAHANDI

9Y M BPL -

04

.02

.20

20

10,000.00 100% - - TA LENTHMI 10,000.00 Nil NilAdhar No

Collected

X

17 SAROJ RANA

C/O KISHARI

RANA AT

JAMBAHALI

DIST

KALAHANDI 12Y M BPL -

04

.02

.20

20

10,000.00 100% - - TA LENTHMI 10,000.00 Nil NilAdhar No

Collected

X

18SUBHADRA

SARAF

C/O GITANJALI

SARAF AT

TARAPUR DIST

KALAHANDI 6Y F BPL -

04

.02

.20

20

10,000.00 100% - - TA

STEADEER 10,000.00 Nil Nil

Adhar No

Collected

X

19SUBASH

MAJHI

C/O KALA MAJHI

AT

JANGERGODA

DIST

KALAHANDI 10Y M BPL -

04

.02

.20

20

10,000.00 100% - - TA STENDER 10,000.00 Nil NilAdhar No

Collected

X

4

Page 5: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

20NIRUPAMA

PUJHARI

C/O

DAMBARUDHAR

PUJHARI AT

BADAPODA DIST

KALAHANDI 8Y F BPL -

04

.02

.20

20

10,000.00 100% - - TRIPLE 10,000.00 Nil NilAdhar No

Collected

X

21 CHAMPA RANA

C/O DURYODHAN

RANA AT GHOTIA

PS GOLANDA DIST

KALAHANDI

ODISHA 6Y F BPL -

04

.02

.20

20

10,000.00 100% - - PLATTER

CASTY 10,000.00 Nil Nil

Adhar No

Collected

X

22 BIKASH NAG

C/O NIRANJAN NAG

AT SALIA PS

LAGIGUS DIST

KALAHANDI

ODISHA 5Y M BPL -

04

.02

.20

20

10,000.00 100% - - BIL. TENDER

RELEASE 10,000.00 Nil Nil

Adhar No

Collected

X

23ROSHAN

GUPTA

C/O BINOD GUPTA

AT MAHIRPADA

DIST KALAHANDI

ODISHA14Y M BPL -

04

.02

.20

20

10,000.00 100% - -

LT. TRIPLE

ARTHODMS

TAL

10,000.00 Nil NilAdhar No

Collected

X

24 TARINI MAJHI

C/O JASODA MAJHI

AT SUNAMAL PS

JARPUT DIST

KALAHANDI 15Y F BPL -

04

.02

.20

20

10,000.00 100% - -

TRIPLE

ORTHO

DENIS

10,000.00 Nil NilAdhar No

Collected

X

2,40,000.00 2,40,000.00 TOTAL…5

Page 6: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1PRABHU PADA

BARIK

AT UJUDA PO

POURSKULI DIST

BALESORE

11M M BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

88

20

93

73

72

2BALKARAM

MARANDI

AT JAMDA PO

MAYURBHANJ

ODISHA

1.6Y M BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

X

3CHANDAN

GHARAI

AT MAHESPUR PO

MAHESPUR DIST

BALESORE

2Y M BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

X

4 LOGO SATTEN

AT SARADA

BANDHA DIST

BALESORE

5Y M BPL -

28

.02

.20

20

10,000.00 100% - - LT. CTEV 10,000.00 Nil NilAdhar No

Collected

X

5

SATYA

NARAYAN

LENKA

AT NUARER PO

BADASIDHIA DIST

BALESORE

3Y M BPL -

28

.02

.20

20

10,000.00 100% - -

RECURRENT

CTEV WITH

AGMC BIL.

10,000.00 Nil NilAdhar No

Collected

X

SURGERY CAMP AT BALESORE DISTRICT ON 28.02.2020 UNDER ADIP SCHEME (B)

6

Page 7: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

6 RIYA NAYAK

AT SURUNI DIST

BALESWORE

3Y M BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

X

7SHAGUFTA

QUADRI

AT/PO RAJPUR

JALESWAR DIST

BALESORE

4Y F BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

94

37

16

94

11

8BISNUPRIYA

BEHERA

AT/PO

HARICHANDAPUR

DIST BALESWOR

6Y F BPL -

28

.02

.20

20

10,000.00 100% - - EQUINUS

FOOT RT. 10,000.00 Nil Nil

Adhar No

Collected

99

38

76

60

51

9PANCHAM

DALEI

AT/PO DEBKUMAR

JALESWAR DIST

BALESORE

6Y F BPL -

28

.02

.20

20

10,000.00 100% - - EQUINUS

FOOT BIL. 10,000.00 Nil Nil

Adhar No

Collected

95

56

87

55

91

10 SURESH PATRA

C/O BIRENDRA

PATRA AT

KENDUKHUNTA PO

RAIBANIA

JALESWAR DIST

BALESWAR

6Y M BPL -

28

.02

.20

20

10,000.00 100% - - EQUINUS

FOOT RT. 10,000.00 Nil Nil

Adhar No

Collected

73

81

20

55

61

7

Page 8: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

11JYOTI PRAKASH

MALLIK

C/O JAGANNATH

MALLICK AT

KHANTAPADA

BAHANGA DIST

BALESWAR 6Y M BPL -

28

.02

.20

20

10,000.00 100% - - INFONTILE

RT. 10,000.00 Nil Nil

Adhar No

Collected

91

78

18

30

15

12

CHINTU

NANDAN

BEHERA

c/o SURENDRA

BEHERA AT

SULSANDA

JALESWAR DIST

BALESORE 8Y M BPL -

28

.02

.20

20

10,000.00 100% - -

RT.

EQUINUS

FOOT

10,000.00 Nil NilAdhar No

Collected

95

56

86

53

89

13PRASANT

SENAPATI

C/O JAYANTA

SENAPATI AT

SIGAKHUTA SORO

DIST BALESORE 8Y M BPL -

28

.02

.20

20

10,000.00 100% - -

RT.

EQUINUS

FOOT

10,000.00 Nil NilAdhar No

Collected

95

56

86

53

89

14 ADITYA KISKU

C/O SARAT BINDHA

AT SADAR DIST

BALESWAR

9Y M BPL -

28

.02

.20

20

10,000.00 100% - - LT. NEGLECT

CTEV 10,000.00 Nil Nil

Adhar No

Collected

95

83

41

81

73

15RAJENDRA

PATRA

C/O SATRUGHNA

PATRA , AT PALSA

KHAIRA

DISTBALESWOR9Y M BPL -

28

.02

.20

20

10,000.00 100% - -

RT.

EQUINUS

FOOT

10,000.00 Nil NilAdhar No

Collected

95

56

74

69

49

8

Page 9: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

16CHANDANA

DAS

AT DATUN WB

9Y F BPL -

28

.02

.20

20

10,000.00 100% - -

RT.

NEGLECTED

CTEV

10,000.00 Nil NilAdhar No

Collected

62

94

44

94

01

17 TAPAN BEHERA

AT KUNJIARI

SIMALIA DIST

BALESWAR

10Y M BPL -

28

.02

.20

20

10,000.00 100% - - CP WITH

MR. 10,000.00 Nil Nil

Adhar No

Collected

80

18

64

27

39

18 SAMIT RANJAN

AT PODASOD

DAHISAHI NIGIRI

DIST BALESWAR

10Y M BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

X

19BABIRANI

ANDIA

AT KALIAPUR

JALESWAR DIST

BALESWAR

14Y M BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

70

64

19

97

48

20 SAI NAYAK

AT BANGIRIPOSI

DIST BALESORE

10M M BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

77

35

88

55

20

9

Page 10: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

21PRATUSH KU

MOHANTY

AT AGHIRAPADA

OUPADA DIST

BALESORE

5Y M BPL -

28

.02

.20

20

10,000.00 100% - -

INTITILE

HEMI WITH

CP

10,000.00 Nil NilAdhar No

Collected

80

72

39

00

65

22 KETAI PANDA

C/O RANA CH.

PANDA AT

SABANGA SINULIA

DIST BALESORE 6Y F BPL -

28

.02

.20

20

10,000.00 100% - - EQUINUS

FOOT BIL. 10,000.00 Nil Nil

Adhar No

Collected

80

18

08

13

76

23 PUJA KANILA

C/O RABINDRA

KANILA AT BARIPUR

BAHANGA DIST

BALESORE11Y M BPL -

28

.02

.20

20

10,000.00 100% - - NEGLETED

CTEV BIL. 10,000.00 Nil Nil

Adhar No

Collected

76

06

96

03

06

24MONALISHA

PARIDA

C/O MANORANJAN

PARIDA AT BALIPAL

SADAR DIST

BALESORE 17Y F BPL -

28

.02

.20

20

10,000.00 100% - - NEGLECTED

CTEV BIL. 10,000.00 Nil Nil

Adhar No

Collected

78

53

08

39

14

25GAYATRI

BINDHANI

C/O KARTIK

BINDHANI AT

BEGAMPUR PO

NARAHARI PUR

DIST BALESORE10Y F BPL -

28

.02

.20

20

10,000.00 100% - - LT. EQUNES

FOOT 10,000.00 Nil Nil

Adhar No

Collected

82

60

27

27

16

10

Page 11: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

26 S K KALAM

C/O SK JAKIR AT

RAM CH. PUR

SADAR DIST

BALESORE12Y M BPL -

28

.02

.20

20

10,000.00 100% - -

INFUNTILE

HEMIPLAGI

A LT.

10,000.00 Nil NilAdhar No

Collected

76

09

96

92

45

27GETARANI

GHOSH

C/O AJAY GHOSH

AT BALIA PO

REMUNA DIST

BALESORE11Y F BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

93

37

64

08

60

28PRADEEP

MOHANTY

C/O SHAKTI PANDA

MOHANTY AT

DEULA BHOGARAI

DIST BALESORE 11Y M BPL -

28

.02

.20

20

10,000.00 100% - -

TA TIGHT

NESS CTEV

LT.

EQUINUS

LT.

10,000.00 Nil NilAdhar No

Collected

X

29CHATRABHUJA

DAS

C/O JAGANNATH

DAS AT ANALIA

BHOGRALI DIST

BALESWAR 13Y M BPL -

28

.02

.20

20

10,000.00 100% - -

INFANTILE

HEMIPLEGIA

LT.

10,000.00 Nil NilAdhar No

Collected

X

30RAJASHREE

JENA

C/O F. AKHAYA

JENA AT NISCHINTA

SIMULIA DIST

BALESWAR13Y F BPL -

28

.02

.20

20

10,000.00 100% - - LT. CTEV

AND CP 10,000.00 Nil Nil

Adhar No

Collected

63

80

66

82

50

11

Page 12: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

31 LOVELY SINGH

C/O MANJULATA

SINGH AT

LINGAPADA SORO

DIST BALESORE 12Y F BPL -

28

.02

.20

20

10,000.00 100% - -

CP WITH

HANSTUNG

TIGHT NESS

10,000.00 Nil NilAdhar No

Collected

X

32CHANDANA

DAS

C/O JINE DAS AT

DANTURU WB

9Y F BPL -

28

.02

.20

20

10,000.00 100% - - BIL. CTEV 10,000.00 Nil NilAdhar No

Collected

62

94

44

94

01

33SARMAN

KHATUN

C/O SK SIRAJUDDIN

GOPINATH PUR

BASTA BALESWOR

12Y F BPL -

28

.02

.20

20

10,000.00 100% - -

EQUINUS

FOOT AND

TA

TIGHTNESS

10,000.00 Nil NilAdhar No

Collected

76

05

97

74

53

34RUPENDRA

HEMBRAM

C/O HOPA

HEMBRAM AT

AMBUTANA

JALESWAR DIST

BALESORE 4Y M BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

93

48

85

74

65

35 RAPALI DEY

C/O JANMAJAY DEY

AT BELBARAI PO

JALESWAR DIST

BALESORE 8Y F BPL -

28

.02

.20

20

10,000.00 100% - - RT. CTEV 10,000.00 Nil NilAdhar No

Collected

63

71

75

65

44

12

Page 13: At- Olatpur , P.O- Bairoi , Dist- Cuttack (Odisha ), PIN - 754010 …svnirtar.nic.in/sites/default/files/camp_pmr/Surgery Camp... · 2020. 6. 11. · KALAHANDI 1Y M BPL - 0 10,000.00

Sl.

NO.Name of

beneficiary

Complete

Address

Age Male/

Femal

e

Incom

e

Type

of

Aid

Give

n

Date on

which

given

Total cost of

aid including

fabri-cation/

fitment

charges

Subsi

dy

provid

ed

Tavel

cost

paid

to

out-

stati

Boarding

and

lodging

expenses

paid

Whether

any surgical

correction

under-taken

Total

10+11+12+13

No. of

days for

which

stayed

Wheth

er

accom-

panied

by

escort

Aadhar

Card No.

Photo of bene-

ficiary any

Mobile

No. or

land line

number

with STD

Code**1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

36 SUDHAKAR PAL

C/O KARTIK PAL AT

MAKIDIA JALESORE

DIST BALESORE

7M M BPL -

28

.02

.20

20

10,000.00 100% - - LT. CTEV 10,000.00 Nil NilAdhar No

Collected

87

63

51

29

63

3,60,000.00 3,60,000.00

6,00,000.00 6,00,000.00

TOTAL..

G.TOTAL.. (A+B)

13