s14-4 FORM-5
GOVERNMENT OF GUJARAT
DEPARTMENT OF HEALTH AND FAMILY WELFARE BA 3241274
BIRTH CERTIFICATE
( 3 HRet Üel RtA, 1eEel saH 12/19 u eid y42a Üvel Gun, 201/nt GunC r )
(ssucd under Section 12/17 of the Registration ofBirths and Deaths Act, 1969 and Rule 8of the Gujarat Registrationof Births and Deaths Rules, 2018)
rtigsit gyr Ua/aderl eeaui d.
This is to certify that the following information has been taken from the original record of birth which is in the register for Vill
Bhuj(M) of Taluka Bhuj of District Kachchh of Gujarat State, India. e/City
otl4/Name Ai l HlE / MD ADYAN MURSHEDD d Sex 4 / Male
dlu/Date of Birth 30/08/2023 SoH AN/Place of Birth
Wednesday, August 30, 2023 G.K.Hospital (civil)
Hlrtlg lH/Name of Mother tlg otl/Name of Father:
V tl APSANA SULTANA HleE U»A ydE / MOHAMMAD BAZLE MURSHED
ALNsotl oH HHA Hltl-tlg *Rtly Address of parents Hltl a l s l l aRtLy / Permanent Address of
at the time of Birth
of child Parents
MUNDRA KACHCHH I yoal s9 CARNELGOLA, WARD NO.9, PS. KOTWALI, PO. MIDNAPORE|
DIST. PASCHIM MEDINIPUR, STATE. WEST BENGAL
/solcalau, aa a.e, laa. Bleaudl, UAEatya, y. uA
Tuel sHis/Registration No. : 7749 alugl ol tlflu/Registration Date 02/09/2023
AALS (AAN lu)/Remarks (if any) yHIgua odR/ Certifcate No.: B202310727235
/0
yHIgIUa stál ullol tiilu / Date of issue yAuQua AIUtI? UruAst{ltl Asl Signature of issuing
Authority:
29/09/2023
AGA
DEATH EE1913
SUB REGISTRAR
BIRTH &DEATH
BHUJ NAGARPALIKA
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s14-4 FORM-5
GOVERNMENT OF GUJARAT
DEPARTMENT OF HEALTH AND EAMILY WEL FARE BA 3241274
BIRTH CERTIFICATE
(lssued under Section 12 17ofthe Registration of Births and Deaths Act. 1969 and Rule 8 of the CGujarat Registration of Births and Deaths Rules, 201S)
This is to certify that the following information has been taken from the original record of birth which is in the register for Village/City
Bhuj(M) of Taluka Bhuj of District Kachchh of Gujarat State, India.
otlH/Name Hl Häla / MD ADYAN MURSHED lA Sex / Male
SH dldu/Date of Birth 30/08/2023 H UN/Place of Birth
Wednesday. August 30, 2023 G.K.Hospital (civil)
Hllg tlH/Name of Mother: l g l/Name of Father:
APSANA SULTANA AlENE ALsA ydE 1MOHAMMAD BAZLE MURSHED
GALUS Y AHa Hldl-rtld H2otly/ Address of parents HItl t l g 5ladl azily / Permanent Address of
at the time of Birth of child Parents
MUNDRA KACHCHH1Hoal s229 CARNELGOLA, WARD NO.9, PS. KOTWALI, PO. MIDNAPORE
DIST. PASCHIM MEDINIPUR, STATE. WEST BENGAL
/soltlaI, Aa ie, Vlaa. Seadl, ÀEUYe, Y. YAA
ugll suis/Registration No. : 7749 luel ol atu/Registration Date: 02/09/2023
S (Au lu)/Remarks (if any): yHugUua ouR Ceriíícate No. 8202310727235
/0
yHIua stdl ultl tuálu Date ofissue YHIlua uVtl? UriUAst{ltl asv signature of lssuing
Authority
29/09/2023 JN
AGA
D
DEATR
SUB REGISTRAR
BIRTH& DEATH
BHUJ NAGARPALIKA
14o9YRpridBAkcKLbCUq2q7exCAmauaPJoWs/akpcBy7/FIWu7K56ych4BLX/qHBC
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