No.
00343
                                                                                                        Form -5
                             ANDAMAN & NICOBAR
                                                   ADMINISTRATION
                                   REGISTRAR OF BIRTHS & DEATHS
                                                     BIRTH CERTIFICATE
                                          1999   h   frH 8/13 3rfd
        (lssued under Section 12/17 of the                                fh r )
                   the Andaman &                Registration of Births and Deaths Act, 1969 and
                                      Nicobar Island Registration                                 Rules 8/13 of
                                                                   of Births and Deaths
            This is to certify that the                                                 Rules,  1999)
is the register for                     following information has been taken from the
                     (local area/local body)
District SOUTH ANDAMAN                        MUNICIPAL AREA, PORT BLAIR of Tehsil/Block original record of birth which
                                   of Union Territory                                                 PORT BLAIR of
                                                      ANDAMAN AND NICOBAR ISLANDS.
AREA, PORT BLAIR TEÍTT PORT BLAIR fGI
                                                            SOUTH ANDAMAN s ANDAMAN AND
                                                                                                             NICOBAR
  TA/Name                             :R. PAVITRA
GH faf /Date of Birth                   : 16/02/2006
HIGI  IH/Name of Mother
                                                                  fi/ Sex       : FEMALE
                                        :VALLIAMMA
ftcT  H/Name of Father                  :RAMESH
                                                                  u   RH/Place of birth:
                                                                  G.B.PANT HOSPITAL,PORT BLAIR
 Address   of   parents   at the time of birth of child:
 HADDO                                                            Permanent address of parents:
 PORT BLAIR                                                       HADDO
                                                                  PORT BLAIR
                                                                  A&NISLANDS
 ystory HN/Registration No.              :334 12006               yofthu f&ia/Date of Registration:22/02/2006
 feuuf/Remarks(if any)                   :TIME OF BIRTH:9:35 AM
 G    H         faf /ate     of issue    :15/04/2011
                                                                                     kste issuing authority
                                                                  urfea a YGT/Adress of the issuing authority
                                                                                           3.By0.No-1
                                                                  er/Seal                     ipal Areà
                                                                                             n SeviCes
                "Ensure registration of every birth and death / wràs aa qd gq         itrUr f t s"
                                                                                    6iZPort Slair