4.
1
NO. 1 GOVERNMENT OF BIHAR FORM-5
DEPARTMENT OF PLANNING AND DEVELOPMENT
GRAMA PANCHAYAT KANCHANPUR
BIRTH CERTIFICATE
(ISSUED ÚNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS &DEATHS ACT, 1969AND RULE 8/13 OF THE BIHAR REGISTRATION OF BIRTHS &DEATHS
RULES 1999)
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER FOR GRAMA
PANCHAYAT KANCHANPUR OF TAHSIL/BLOCK BARUN OF DISTRICT AURANGABAD OF STATE/UNION TERRITORY BIHAR, INDIA.
AT& / NAME: iT HT / SUMIT KUMAR faJT |SEX: T64 / MALE
3ATITT / AADHAAR NO.:
XXXXXXXX4138
TH Af DATE OF BIRTH: GH TT/PLACEOF BIRTH:
01-01-2006
FIRST-JANUARY-TWO THOUSAND SIX
faart, 824112
CHARAN
MAHUARI,BARUN, AURANGABAD.
BIHAR, 824112
AAI AI AH I NAME OF MOTHER: fuT H/NAME OF FATHER:
fat ¥ / VIMLA DEV! hsuT z / KRISHNA SINGH
ATITT TTi i MOTHER'S AADHAAR NO: 3TEITT qT / FATHER'S AADHAAR NO:
XXXXXXKX4766
qt * H HHs HAT-fAT I VA /ADDRESS OF PARENTS AT THETIME OF BIRTH HTAT-fU yH/ PERMANENT ADDRESSOF PARENTS:
OF THE CHILD:
aRIT- 824112 fasrr- 82412
CHARAN,MAHUARI, BARUN, AURANGABAD, CHARAN, MAHUARI, BARUN, AURANGABAD,
BIHAR- 824112 BIHAR- 824112
yHG4T /REGISTRATION NUMBER: yftau rra|DATE OF REGISTRATION:
B-2019: 10-07440-000010 03-06-2019
faytt / REMARKS (IF ANY):
arT Àâ af DATE OF ISSUE: râ Tà araI Vfd
6.2019
IssUNG AUTHORITY
19-11-2020
REGISTRAR BIRTH& DEATH)
GRAMA PAEAYATkAÑOHANPUR
UPDATED ON:
19-11-2020 15:10:14
"THIS IS A COMPUTER GENERATED CERTIFICATE. "
" THE GOVT. OF INDIA VIDE CIRCULAR NO. 1/12/2014-VS(CRS) DATED 27-JULY-2015 HAS
APPROVED THIS CERTIFICATE AS AVALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES".
" vàs HÅ H G7U gfrrfea t / ENSURE REGISTRATION OF EVERY BIRTH AND DEATIU"
