Scribd
Upload
164 views1 page

Form-5: Government of West Bengal Department of Health and Family Welfare Gram Panchayat Padima-I

This document is a birth certificate issued by the Government of West Bengal for Koushik Barik, born on March 31, 2004, at Digha Nursing Home in Purba Medinipur. It includes details such as the names of the parents, their identity proofs, and addresses. The certificate is registered under the Registration of Births & Deaths Act, 1969, and is valid for official purposes.

Uploaded by

hasen786khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
164 views1 page

Form-5: Government of West Bengal Department of Health and Family Welfare Gram Panchayat Padima-I

This document is a birth certificate issued by the Government of West Bengal for Koushik Barik, born on March 31, 2004, at Digha Nursing Home in Purba Medinipur. It includes details such as the names of the parents, their identity proofs, and addresses. The certificate is registered under the Registration of Births & Deaths Act, 1969, and is valid for official purposes.

Uploaded by

hasen786khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Form-5

GOVERNMENT OF WEST BENGAL


DEPARTMENT OF HEALTH AND FAMILY WELFARE

GRAM PANCHAYAT PADIMA-I

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 GRAM PANCHAYAT PADIMA-I OF BLOCK/MUNICIPALITY RAMNAGAR - I OF DISTRICT PURBA MEDINIPUR OF
STATE WEST BENGAL, INDIA.

NAME : KOUSHIK BARIK GENDER : MALE

DATE OF BIRTH : 31/03/2004 PLACE OF BIRTH : DIGHA NURSING HOME, RAMNAGAR - I,


PURBA MEDINIPUR, PADIMA-I, WEST
BENGAL

NAME OF MOTHER : LAKSHIPRIYA BARIK NAME OF FATHER : SHASHANKASHEKHAR BARIK

MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX6498


XXXXXXXX0971

PRESENT ADDRESS OF MOTHER VILLAGE/TOWN:- JHARPADIMA,RAMNAGAR - I BLOCK,DIST:- PURBA MEDINIPUR,WEST BENGAL-


AT THE TIME BIRTH OF THE 721446
CHILD :

PERMANENT ADDRESS OF VILLAGE/TOWN:- JHARPADIMA,RAMNAGAR - I BLOCK,DIST:- PURBA MEDINIPUR,WEST BENGAL-


MOTHER : 721446

CERTIFICATE NO : B/2024/1090389 DATE OF REGISTRATION : 07/05/2004


OLD Reg No.1398/2004

S-UHID : 38165854798205 REMARKS (IF ANY) :

DATE OF ISSUE : 07/05/2004 UDIN : ----

UPDATED ON : 2024-08-16 10:39:14 ISSUING AUTHORITY :

Signature Not Verified


Digitally Signed.
Name: ASOK CHANDA
Date: 16-Aug-2024 13:00:13

SUB-REGISTRAR (BIRTH & DEATH)


GRAM PANCHAYAT PADIMA-I

"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"

a5939e42-bb23-ccc4-68ea
The QR Code and Certificate Number can be verified through the portal https://janma-mrityutathya.wb.gov.in

You might also like