Form-5
GOVERNMENT OF WEST BENGAL
DEPARTMENT OF HEALTH AND FAMILY WELFARE
KOLKATA MUNICIPAL CORPORATION
BIRTH CERTIFICATE
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE WEST BENGAL
REGISTRATION OF BIRTHS & DEATHS RULES 2000.)
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS
THE REGISTER FOR KOLKATA MUNICIPAL CORPORATION OF BLOCK/MUNICIPALITY BOROUGH 08 OF DISTRICT KOLKATA OF
STATE WEST BENGAL, INDIA.
NAME : PANKAJ NASKAR GENDER : MALE
DATE OF BIRTH : 01/01/1968 PLACE OF BIRTH : VII :PATHARGHATA PO-PATHARGHATA
PS-RAJARHAT NORTH 24 PGS KOLKATA
700135
NAME OF MOTHER : PARULBALA NASKAR NAME OF FATHER : ANIL CHANDRA NASKAR
MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX1999
XXXXXXXX2467
PRESENT ADDRESS OF MOTHER VII : VII :PATHARGHATA PO-PATHARGHATA PS-
AT THE TIME BIRTH OF THE RAJARHAT NORTH 24 PGS KOLKATA 700135
CHILD :
PERMANENT ADDRESS OF VII : VII :PATHARGHATA PO-PATHARGHATA PS-
MOTHER : RAJARHAT NORTH 24 PGS KOLKATA 700135
CERTIFICATE NO : I/08/2022/007458 DATE OF REGISTRATION : 14/05/2022
S-UHID : REMARKS (IF ANY) :
DATE OF ISSUE : 18/08/2022 UDIN : --
UPDATED ON : 2022-08-18 15:56:38 ISSUING AUTHORITY :
SUB-REGISTRAR (BIRTH & DEATH)
KOLKATA MUNICIPAL CORPORATION
"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 A VALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES
"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH"
The QR Code and Certificate Number can be verified through the portal https://janma-mrityutathya.wb.gov.in
