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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(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)
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IhRƨ\hShɀkDhWhUh5SD^sP˴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
Dantkarodi of Taluka Chanasma of District Patan of Gujarat State, India.
Wh\Name : XN°_ɅkK_Ȣk\h^PATEL SUJALKUMAR ĤiSSex : ڧڔἘڟMale
Kƛ\Sh^EDate of Birth : 21/11/2003 Kƛ\ƨT`Place of Birth :
Friday, November 21, 2003 255,patelvas,dantkarodi
\hShȵk5Wh\Name of Mother : iXShȵk5Wh\Name of Father :
ٷڛڬڊڔἿژ᷷ړڬږڤڛPATEL URMILABEN XN°_ZpI^[h9PATEL BECHARBHAI
Zh`DWhKƛ\d\]p\hShiXShȵk5d^WhȺk5Address of parents \hShiXShȵk5Dh]\jd^WhȺk5Permanent Address of
at the time of Birth of child : Parents :
255,patelvas,dantkarodi / ڦڌگښڀڏٱڤڑڠڤڝڛڬڊڔ 255,patelvas,dantkarodi ڦڌگښڀڏٱڤڑڠڤڝڛڬڊڔ
WҭVRj˲\h5DRegistration No. : 5 WҭVRjWjSh^ERegistration Date : 25/11/2003
^\hD½d iabpcWҭV Remarks (if any) : ̆\hRX́W5Z^Certificate No. : B200310008725
̆\hRX́DhQ8Ɯ]hWjSh^EDate of issue : ̆\hRX́8XWh^dĂhiVDh^WjdeSignature of Issuing
Authority :
17/06/2024 ..................................................................................
Registrar ( Birth & Death )
^Kƨ˼h^ Kƛ\\^R
Dantkarodi , Patan
..
Disclaimer : This is a computer generated extract of birth register. In case of any objection, please contact concerned Registrar (B&D).
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