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DOB Naitik PDF

This document is a birth certificate for Naitik Gautam born on April 11, 2018 in Mishrauli Taluka Maniyar, Uttar Pradesh, India. It provides details of the child such as name, gender, date and place of birth. It also lists the names and identification numbers of the mother Anita and father Nikhilesh, as well as their current and permanent addresses in Ismailpur Barahati, Uttar Pradesh. The certificate was issued on December 7, 2021 and contains the registration number and date of registration for the birth.

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lalit kashyap
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1K views1 page

DOB Naitik PDF

This document is a birth certificate for Naitik Gautam born on April 11, 2018 in Mishrauli Taluka Maniyar, Uttar Pradesh, India. It provides details of the child such as name, gender, date and place of birth. It also lists the names and identification numbers of the mother Anita and father Nikhilesh, as well as their current and permanent addresses in Ismailpur Barahati, Uttar Pradesh. The certificate was issued on December 7, 2021 and contains the registration number and date of registration for the birth.

Uploaded by

lalit kashyap
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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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
ाम पंचायत मौल तालुका मनयार
GRAMA PANCHAYAT MISHRAULI TALUKA MANIYAR

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 ाम पंचायत मौल तालुका मनयार तहसील बांसडीह िजला बलया
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
GRAMA PANCHAYAT MISHRAULI TALUKA MANIYAR OF TAHSIL/BLOCK BANSDIH OF DISTRICT BALLIA OF STATE/UNION TERRITORY UTTAR PRADESH,
INDIA.

नाम / NAME: NAITIK GAUTAM लंग / SEX: पुरष / MALE

जम तथ / DATE OF BIRTH: जम थान/ PLACE OF BIRTH:


11-04-2018
ELEVENTH-APRIL-TWO THOUSAND EIGHTEEN MISHRAULI TALUKA MANIYAR,BANSDIH, BALLIA,
UTTAR PRADESH

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


ANITA NIKHILESH

आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
XXXXXXXX4156
XXXXXXXX2487

बचे के जम के समय माता-पता का पता / ADDRESS OF PARENTS AT THE TIME माता-पता के थायी पता/ PERMANENT ADDRESS OF PARENTS:
OF BIRTH OF THE CHILD:
VILL - ISMAILPUR BARAHATI, VILL - ISMAILPUR BARAHATI,
POST - KATAULI KALAN, ISMAILPUR BARHATI, , LALGANJ, AZAMGARH, UTTAR POST - KATAULI KALAN, ISMAILPUR BARHATI, LALGANJ,
PRADESH- 276202 AZAMGARH,
UTTAR PRADESH- 276202

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


B-2021: 9-45858-000418 07-12-2021

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
07-12-2021
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
ाम पंचायत मौल तालुका मनयार
GRAMA PANCHAYAT MISHRAULI TALUKA MANIYAR

UPDATED ON :
07-12-2021 10:10:28

"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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