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Pesons Centred Plan(व्यक्ति केन्द्रित योजना)
60 A Radhey Puri Ext-1 Jagatpuri Crossing Delhi-110051
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Name of the Student
*
Your answer
Fathers Name
Your answer
Mothers Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address
Your answer
Contact Details
Your answer
Meeting Date
MM
/
DD
/
YYYY
Indicate the Disability If Any
*
Intellictual Disability
Autism Spectrum Disorder
Cerebral Palsy
Speech and Language Disability
Hearing Impairement(Deaf and Hard of Hearing)
Multiple Disability (Including Deaf Blindness)
Mental Illness
Dwarflism
Chronic Neurological Condition
Locomotor Disability
Blindness
Low Vision
Muscular Disability
Leprosy Cured Persons
Multiple Sclerosis
Thalassemia
Hemophilia
Sickle Cell Disease
Acid Attack Victim
Parkinsons Disease
Non Disablied
Medical History(If Any)
*
Your answer
School Record History
Option 1
Clear selection
Who will support you at home for Acdemic Abilities
*
Mother
Father
Mother and Father
Grand Parents
Siblings
Teacher
Caregiver
Any Other
Who will support you at home for Daily Life Activities?
*
Mother
Father
Father and Mother
Grand Parents
Siblings
Caregiver
Any Other
Who will support you at home for Lesuire Time Activities?
*
Father
Mother
Mother and Father
Grand Parents
Siblings
Teachers
Caregiver
Any Other
What is your hobbies and interest ?
*
Your answer
What is you like to enjoy doing ?
*
Your answer
How much family involve to support to their ward ?
*
Totally
Partialy
Frequent
Never
What Service you like to join in Manovikas eGYANSHALA
Pre School Support (Aarambh Child Care Centre (A3C))
Open School Support (Open Based Education 1 to 3 Class)
Open School Support (Open Based Education 4 to 8 Class)
Open School Support (Open Based Education 10 Class or Secondary)
Open School Support (Open Based Education Level 12 Class 0r Senior Secondary)
Skill Training Program
Quality of Life Support (QOL)
Option 8
Clear selection
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