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    MPDF

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    LAX

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    MPDF

    Uploaded by

    Laxman Bhakat
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    LAX

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    mpdf

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    LAX

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    8 views1 page

    MPDF

    Uploaded by

    Laxman Bhakat
    LAX

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    of 1

    झारखंड सरकार

    सं . 1 GOVERNMENT OF JHARKHAND प-5


    No. 1 (अथ एवं सांियकी िनदे शालय) FORM-5
    DEPARTMENT OF ECONOMICS & STATISTICS

    BOKARO SADAR HOSPITAL

    जम माण-प
    BIRTH CERTIFICATE

    (जम मृ यु रिजट ीकरण अिधिनयम, 1969 की धारा 12 / 17 तथा झारखं ड जम मृ यु रिजट ीकरण िनयम, 2009 के िनयम 8/13 के अं तगत जारी िकया गया )
    (ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE JHARKHAND
    REGISTRATION OF BIRTHS & DEATHS RULES 2009.)

    यह मािणत िकया जाता है िननिलिखत सूचना जम के मूल अिभले ख से ली गई है जो िक बोकारो सदर होिपटल तहसील बे रमो िजला बोकारो राय/सं घ दे श झारखं ड , 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 BOKARO SADAR HOSPITAL OF TAHSIL/BLOCK BERMO OF DISTRICT BOKARO OF STATE/UNION TERRITORY JHARKHAND,
    INDIA.

    नाम / NAME : KAUSHIK BHAKAT िलं ग / SEX : MALE

    जम ितिथ / DATE OF BIRTH:


    01-03-2007 जम थान / PLACE OF BIRTH :
    FIRST-MARCH-TWO THOUSAND SEVEN GOLKATA

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


    SIVANI BHAKAT MADAN BHAKAT

    आधार नं बर / MOTHERS AADHAAR NO : आधार नं बर / FATHERS AADHAAR NO:


    XXXXXXXX0870 XXXXXXXX1492

    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 : GOLKATA VILLAGE -GOLKATA POST -BEKO P.S MGM DIMNA
    GOLKATA VILLAGE -GOLKATA POST -BEKO P.S MGM DIMNA BLOCK- BLOCK-JUGSALAI DISTRICT - EAST SINGHBHUM STATE -
    JUGSALAI DISTRICT - EAST SINGHBHUM STATE -JHARKHAND PIN CODE- JHARKHAND PIN CODE- 832304
    832304

    पं जीकरण सं या / REGISTRATION NUMBER: पं जीकरण तारीख / DATE OF REGISTRATION:


    B-2023: 9-90347-0038 21-12-2023

    िटपणी / REMARKS (IF ANY):


    ---

    जारी करने की ितिथ / DATE OF ISSUE : जारी करने वाला ािधकारी / ISSUING AUTHORITY :
    19-12-2023
    रिजटार (जम एवं मृ यु )
    REGISTRAR (BIRTH & DEATH)

    BOKARO SADAR HOSPITAL

    UPDATED ON :
    19-12-2023 11:01:44

    "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".

    " ये क जम एवं मृ यु का पं जीकरण सु िनिचत कर "/ ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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