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    SignedBirthCertificate 9609059 782

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    c.ur.t.ismo.oney5.7.1

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    SignedBirthCertificate 9609059 782

    Uploaded by

    c.ur.t.ismo.oney5.7.1
    9 views1 page

    Original Title

    SignedBirthCertificate_9609059_782

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    9 views1 page

    SignedBirthCertificate 9609059 782

    Uploaded by

    c.ur.t.ismo.oney5.7.1

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Form-5

    GOVERNMENT OF WEST BENGAL


    DEPARTMENT OF HEALTH AND FAMILY WELFARE

    SUB DIVISIONAL HOSPITAL BOLPUR

    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 SUB DIVISIONAL HOSPITAL BOLPUR OF BLOCK/MUNICIPALITY MUNICIPALITY BOLPUR OF DISTRICT
    BIRBHUM OF STATE WEST BENGAL, INDIA.

    NAME : SK TAKRIM RAHAMAN GENDER : MALE

    DATE OF BIRTH : 10/01/2024 PLACE OF BIRTH : SUB DIVISIONAL HOSPITAL BOLPUR,


    MUNICIPALITY BOLPUR, BIRBHUM, WEST
    BENGAL

    NAME OF MOTHER : HAZERA KHATUN NAME OF FATHER : SK ATAHER RAHAMAN

    MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX4769


    XXXXXXXX1319

    PRESENT ADDRESS OF MOTHER LOCALITY:- PARAJ,VILLAGE/TOWN:- PARAJ,GALSI - I BLOCK,DIST:- PURBA BARDHAMAN,WEST


    AT THE TIME BIRTH OF THE BENGAL-
    CHILD :

    PERMANENT ADDRESS OF LOCALITY:- PARAJ,VILLAGE/TOWN:- PARAJ,GALSI - I BLOCK,DIST:- PURBA BARDHAMAN,WEST


    MOTHER : BENGAL-

    CERTIFICATE NO : B/2024/0095031 DATE OF REGISTRATION : 16/01/2024

    S-UHID : 34907097203630 REMARKS (IF ANY) :

    DATE OF ISSUE : 16/01/2024 UDIN : ----

    UPDATED ON : 2024-01-16 12:06:37 ISSUING AUTHORITY :

    Signature Not Verified


    Digitally Signed.
    Name: SIRAJUDDOLLA SEKH
    Date: 16-Jan-2024 14:35:41

    SUB-REGISTRAR (BIRTH & DEATH)


    SUB DIVISIONAL HOSPITAL BOLPUR

    "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"

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