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Hello Aspirant,
As per the information bulletin released by NTA for NEET UG 2021, the Disability certificate should be issued only by the 13 centers listed in the information bulletin in Appendix-VIII B and f=the certificate should be in prescribed format as available on Appendix-VIII A other than these criterion no other format or issuing center will be accepted. So if you are from UP then in UP there is only one designated center that is Institute of Medical Sciences, Banaras Hindu University, so the form which you have issued from CMO Kaushambi won't work.
The designated centers by NTA for issuing of disability certificate and the format of disability certificate can be checked from the information bulletin whose link is given below, when you visit just go to the Appendix-VIII A and VIII B :
https://ntaneet.nic.in/webinfo/File/GetFile?FileId=2&LangId=P
I hope this information helps you.
Good Luck!!
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