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This document is a birth certificate issued by the Government of Uttar Pradesh, certifying the birth of Avika Singh on July 28, 2020, at St. Joseph Hospital in Lucknow. It includes details such as the names of the parents, their Aadhaar numbers, and addresses at the time of the child's birth. The certificate is issued under the Registration of Births & Deaths Act, 1969, and is recognized as a valid legal document for official purposes.

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Gaurav218
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46 views1 page

MPDF

This document is a birth certificate issued by the Government of Uttar Pradesh, certifying the birth of Avika Singh on July 28, 2020, at St. Joseph Hospital in Lucknow. It includes details such as the names of the parents, their Aadhaar numbers, and addresses at the time of the child's birth. The certificate is issued under the Registration of Births & Deaths Act, 1969, and is recognized as a valid legal document for official purposes.

Uploaded by

Gaurav218
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
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सं.

1 उर देश सरकार प-5


NO. 1 GOVERNMENT OF UTTAR PRADESH FORM-5
चकसा एवं वाय वभाग
DEPARTMENT OF MEDICAL AND HEALTH
नगर नगम लखनऊ े 4
NAGAR NIGAM LUCKNOW ZONE 4

जम माण-प
BIRTH CERTIFICATE

(जम मृयु रिजकरण अधनयम, 1969 क धारा 12 / 17 तथा उर देश जम मृयु रिजकरण नयम, 2002 के नयम 8/13 के अंतगत जार कया गया
)
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE UTTAR PRADESH REGISTRATION
OF BIRTHS & DEATHS RULES 2002)

यह मािणत कया जाता है ननलिखत सूचना जम के मूल अभलेख से ल गई है जो क नगर नगम लखनऊ े 4 तहसील लखनऊ िजला लखनऊ
राय/संघ देश उर देश, भारत के रिजटर म उिलिखत है ।
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER
FOR NAGAR NIGAM LUCKNOW ZONE 4 OF TAHSIL/BLOCK LUCKNOW OF DISTRICT LUCKNOW OF STATE/UNION TERRITORY UTTAR PRADESH, INDIA.

नाम / NAME: AVIKA SINGH लंग / SEX: महला / FEMALE

जम तथ / DATE OF BIRTH:


जम थान/ PLACE OF BIRTH:
28-07-2020
ST JOSEPH HOSPITAL
TWENTY-EIGHTH-JULY-TWO THOUSAND TWENTY

माता का नाम / NAME OF MOTHER: पता का नाम / NAME OF FATHER:


ASMITA SINGH GAURAV SINGH

आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
XXXXXXXX8829
XXXXXXXX7923

बचे के जम के समय माता-पता का पता / ADDRESS OF PARENTS AT THE TIME OF माता-पता के थायी पता/ PERMANENT ADDRESS OF PARENTS:
BIRTH OF THE CHILD:
3/267, VIVEK KHAND , 3/267, VIVEK KHAND,
GOMTI NAGAR, LUCKNOW, , LUCKNOW, LUCKNOW, UTTAR PRADESH- 226010 GOMTI NAGAR, LUCKNOW, LUCKNOW, LUCKNOW,
UTTAR PRADESH- 226010

पंजीकरण संया / REGISTRATION NUMBER: पंजीकरण तारख / DATE OF REGISTRATION:


B-2020: 9-91809-003424 29-07-2020

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
24-08-2022
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
नगर नगम लखनऊ े 4
NAGAR NIGAM LUCKNOW ZONE 4

UPDATED ON :
24-08-2022 16:09:46

"THIS IS A COMPUTER GENERATED CERTIFICATE WHICH CONTAINS FACSIMILE SIGNATURE OF THE ISSUING AUTHORITY"
" 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".

" येक जम एवं मृयु का पंजीकरण सुनचत कर" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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