BirthCertificate 7372832

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Form-5

GOVERNMENT OF WEST BENGAL


DEPARTMENT OF HEALTH AND FAMILY WELFARE

GRAM PANCHAYAT DHAPDHAPI-II

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 DHAPDHAPI-II OF BLOCK/MUNICIPALITY BARUIPUR OF DISTRICT SOUTH 24 PARGANAS
OF STATE WEST BENGAL, INDIA.

NAME : AYESHA LASKAR GENDER : FEMALE

DATE OF BIRTH : 26/10/2022 PLACE OF BIRTH : SURJAPUR ADARSHA NURSING HOME,


BARUIPUR, SOUTH 24 PARGANAS,
DHAPDHAPI-II, WEST BENGAL

NAME OF MOTHER : ROHIDA LASKAR NAME OF FATHER : RAKIB LASKAR

MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX0255


XXXXXXXX4209

PRESENT ADDRESS OF MOTHER STREET/LANE:- KUSUMBA MAJHER PARA,LOCALITY:- P.O-NARENDRAPUR,VILLAGE/TOWN:- RAJPUR


AT THE TIME BIRTH OF THE SONARPUR,MUNICIPALITY RAJPUR SONARPUR MUNICIPALITY,DIST:- SOUTH 24 PARGANAS,WEST
CHILD : BENGAL-700103

PERMANENT ADDRESS OF STREET/LANE:- KUSUMBA MAJHER PARA,LOCALITY:- P.O-NARENDRAPUR,VILLAGE/TOWN:- RAJPUR


MOTHER : SONARPUR,MUNICIPALITY RAJPUR SONARPUR MUNICIPALITY,DIST:- SOUTH 24 PARGANAS,WEST
BENGAL-700103

CERTIFICATE NO : B/2022/586520 DATE OF REGISTRATION : 31/10/2022

S-UHID : 56619455359397 REMARKS (IF ANY) :

DATE OF ISSUE : 01/11/2022 ISSUING AUTHORITY :

UPDATED ON : 2022-10-31 11:55:13

Signature Not Verified


Digitally Signed.
Name: MAHUYA DAS MONDAL
Date: 01-Nov-2022 16:12:02

SUB-REGISTRAR (BIRTH & DEATH)


GRAM PANCHAYAT DHAPDHAPI-II

"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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