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    Aqsa

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    Nasim Alam

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    © All Rights Reserved
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    Aqsa

    Uploaded by

    Nasim Alam
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    aqsa_(2)

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    Aqsa

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    Nasim Alam

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    of 1

    सं.

    1 बहार सरकार प-5


    NO. 1 GOVERNMENT OF BIHAR FORM-5
    योजना और वकास वभाग
    DEPARTMENT OF PLANNING AND DEVELOPMENT
    सदर अपताल कशनगंज
    SADAR HOSPITAL KISHANGANJ

    जम माण-प
    BIRTH CERTIFICATE

    (जम मृयु रिजकरण अधनयम, 1969 क धारा 12 / 17 तथा बहार जम मृयु रिजकरण नयम, 1999 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 BIHAR REGISTRATION OF
    BIRTHS & DEATHS RULES 1999)

    यह मािणत कया जाता है ननलिखत सूचना जम के मूल अभलेख से ल गई है जो क सदर अपताल कशनगंज तहसील कशनगंज िजला कशनगंज
    राय/संघ देश बहार, 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 SADAR HOSPITAL KISHANGANJ OF TAHSIL/BLOCK KISHANGANJ OF DISTRICT KISHANGANJ OF STATE/UNION TERRITORY
    BIHAR, INDIA.

    नाम / NAME: AQSA PARWEEN लंग / SEX: महला / FEMALE

    जम तथ / DATE OF BIRTH:


    जम थान/ PLACE OF BIRTH:
    25-09-2023
    SADAR HOSPITAL KISHANGANJ
    TWENTY-FIFTH-SEPTEMBER-TWO THOUSAND TWENTY THREE

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


    AMINA KHATUN NASIM ALAM

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

    बचे के जम केसमय माता-पता का पता/ ADDRESS OF PARENTS AT THE TIME OF माता-पता के थायी पता/ PERMANENT ADDRESS OF
    BIRTH OF THE CHILD: PARENTS:
    MITHAPUR WARD NO 04 ,
    DALKHOLA, , DALKHOLA, UTTAR DINAJPUR, WEST BENGAL- 733201 MITHAPUR WARD NO 04,
    DALKHOLA, DALKHOLA, UTTAR DINAJPUR,
    WEST BENGAL- 733201

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


    B-2023: 10-90278-004540 12-10-2023

    टपणी / REMARKS (IF ANY):


    ---

    जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
    12-10-2023
    रिजार (जम एवं मृयु)
    REGISTRAR (BIRTH & DEATH)
    सदर अपताल कशनगंज
    SADAR HOSPITAL KISHANGANJ

    UPDATED ON :
    12-10-2023 08:05:50

    "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".

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

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