Ys\½}FORM - 5
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GOVERNMENT OF GUJARAT
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DEPARTMENT OF HEALTH AND FAMILY WELFARE
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BIRTH CERTIFICATE
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. ȤkK^hSKƛ\\^RWҭVRjiW]\szxyWhiW]\ȺkKZ
(Issued under Section 12/17 of the Registration of Birth and Death Act,1969
and Rule 8 of the Gujarat Registration of Birth and Deaths Rules 2018)
8Tj̆\hRjSD^ah\h58apJpD°WjIpWj\heSjKƛ\WhȺl`^°DP½\h5Tj_pah\h58ajJpȐ[h^SWhȤkK^hS^hԌ]WhDƍJKƣ_hWh
WÉhRhShɀkDhWhMangvana ˴h\be°^Wh^KƨN^\h5Jp
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
Mangvana of Taluka Nakhatrana of District Kachchh of Gujarat State, India.
Wh\Name : Dh5ShZpWKantaben ĤiSSex : ḚṏڦFemale
Kƛ\Sh^EDate of Birth : 03/10/1989 Kƛ\ƨT`Place of Birth :
Tuesday, October 3, 1989 PHC Hospital
\hShȵk5Wh\Name of Mother : iXShȵk5Wh\Name of Father :
ړڬږڛڤژMalben _Ǜ\R[h9Laxmanbhai
Zh`DWhKƛ\d\]p\hShiXShȵk5d^WhȺk5Address of parents \hShiXShȵk5Dh]\jd^WhȺk5Permanent Address of
at the time of Birth of child : Parents :
at. mangvana / ڤڎڤڝڂٱژڧژ at. mangvana ڤڎڤڝڂٱژڧژ
WҭVRj˲\h5DRegistration No. : 35 WҭVRjWjSh^ERegistration Date : 23/03/2023
^\hD½d iabpcWҭV Remarks (if any) : ̆\hRX́W5Z^Certificate No. : B202320232169
/47,2021
̆\hRX́DhQ8Ɯ]hWjSh^EDate of issue : ̆\hRX́8XWh^dĂhiVDh^WjdeSignature of Issuing
Authority :
07/06/2024 ..................................................................................
Registrar ( Birth & Death )
^Kƨ˼h^ Kƛ\\^R
Mangvana , Kachchh
Disclaimer : This is a computer generated extract of birth register. In case of any objection, please contact concerned Registrar (B&D).
MrusIHDMgkqYA7FwfBz4o1sd+sDD5FcTK8bTckAp4qURbyyoSXY7aawE0OczpDGS
