Office of the State Commissioner for Persons with Disabilities
Online Complaint Registration Form
Date
Select District
Select
ADILABAD
KUMARAMBHEEM-ASIFABAD
MANCHERIAL
NIRMAL
NIZAMABAD
JAGITYAL
PEDDAPALLI
JAYASHANKAR-BHUPALAPALLI
BHADRADRI-KOTHAGUDEM
MAHABUBABAD
WARANGAL
HANUMAKONDA
KARIMNAGAR
RAJANNA-SIRICILLA
KAMAREDDY
SANGAREDDY
MEDAK
SIDDIPET
JANGAON
YADADRI-BHUVANGIRI
MEDCHAL - MALKAJIGIRI
HYDERABAD
RANGAREDDY
VIKARABAD
MAHABUBNAGAR
JOGULAMBA-GADWAL
WANAPARTHY
NAGARKURNOOL
NALGONDA
SURYAPET
KHAMMAM
MULUGU
NARAYANPET
Name of Applicant
Age
Gender
--Select--
Male
Female
Other
Address for Communication (Present)
Address for Communication (Correspondence)
Mobile
Type of Disability
Select
Mental Illness
Autism Spectrum Disorder
Cerebral Palsy
Muscular Dystrophy
Chronic Neurological conditions
Specific Learning Disabilities
Multiple Sclerosis
Speech and Language disability
Thalassemia
Hemophilia
Sickle Cell disease
Multiple Disabilities including deafblindness
Acid Attack victim
Parkinsons disease
Disability Certificate Number
Percentage of Disability
Disability Certificate Proof (Upload)
Issuing Authority
Valid Upto
W/o, S/o, D/o
Complaint Description
Supplementary Attachment
Respondent Name
Respondent Address