Form 10IA

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FORM NO.

10-IA
[See sub-rule (2) of rule 11A]

Certificate of the medical authority for certifying ‘person with disability’, ‘severe
disability’, ‘autism’, ‘cerebral palsy’ and ‘multiple disability’ for purposes of section
80DD and section 80U
Certificate No. D911EB32FP01V

Date : 30-07-2023

son/daughter of Shri Ram Reddy , age


This is to certify that Shri/Smt./Ms KARADULA.VENKAT REDDY
years 78 male residing at Begumpet , Registration No. E74G60 is a person
with Critical illness suffering from Renial Cancer Stage IV Also called terminal cancer
2. This condition is non-progressive not likely to improve.
3. Reassessment is not recommended after a period of 2024

Sd/-

(Neurologist/Oncology/ Chief Medical Officer*)


Name :
Address of Institution/Government hospital :

Qualification/designation of specialist :

SEAL

Signature/Thumb impression* of the patient


Note : *Strike out whichever is not applicable.

Printed from www.incometaxindia.gov.in Page 1 of 1

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