Nasha Mukti Kendra Registration — Gyanshakti Pashupalan Foundation

1. Centre Information / केंद्र की जानकारी

Name of Centre / केंद्र का नाम *

Type of Centre *

Registered Under *

Year Established *

1b. Centre Photo / केंद्र की फोटो

Upload Centre Photo / केंद्र की फोटो अपलोड करें

2. Location & Contact / पता एवं संपर्क

Full Address / पूरा पता *

City / Town *

District *

State *

PIN Code *

Phone / Mobile *

Email *

Website (if any)

3. Applicant / Authorised Representative / आवेदक

Full Name *

Designation *

Mobile *

Email *

Applicant / Authorised Representative Photo / आवेदक का फोटो

Click to upload
photo

Upload a recent passport-size photograph of the Applicant / Authorised Representative.

• Passport size photo (white or light background)
• JPG, PNG format — max 2 MB
• Photo will appear on the registration PDF
• आवेदक का हालिया पासपोर्ट साइज फोटो अपलोड करें

4. Capacity & Facilities / क्षमता एवं सुविधाएं

Total Bed Capacity *

Male Beds *

Female Beds *

Available Facilities (select all that apply)

5. Staff Details / कर्मचारी विवरण

Psychiatrists / Doctors *

Counsellors *

Social Workers *

Nurses / Para-Medical *

Other Support Staff

6. Documents Enclosed / संलग्न दस्तावेज़

Select all documents you are enclosing with this application.

Certificate of Pledge — Nasha Mukt Bharat Abhiyaan

Department of Social Justice & Empowerment, Government of India

Gyanshakti Pashupalan Foundation has taken the "Say No to Drugs" pledge under the Nasha Mukt Bharat, Khushhaal Bharat initiative and is committed to consciously stay away from drug abuse and promote a healthy, sober lifestyle.

Certificate of Pledge — Nasha Mukt Bharat Abhiyaan, Government of India — Gyanshakti Pashupalan Foundation

Certificate No: GPNMBA1656467307Date: 29-Sep-2026Signed by: Dr. Sandeep R Rathod, Joint Secretary

Government of India — e-ANUDAAN Registration

Verified NGO

Ministry of Social Justice & Empowerment, Government of India

NGO ID

BR/00043879

Registered Name

GYANSHAKTI PASHUPALAN FOUNDATION

Portal

e-ANUDAAN — NGO/CBO/Startup & Other Organizations Registry

7. Declaration / घोषणा

I hereby solemnly declare that all information furnished in this application is true, correct and complete to the best of my knowledge and belief. I undertake to comply with all rules, regulations and guidelines issued by the Ministry of Social Justice & Empowerment (MSJE) / State Nodal Agency. I understand that any false information may lead to rejection or cancellation of registration.

I accept the above declaration. / मैं उपरोक्त घोषणा स्वीकार करता/करती हूँ।

नशा मुक्ति केंद्र

पंजीकरण आवेदन