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    Adarsh Yadav

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    riturawat19945

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    © All Rights Reserved
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    Adarsh Yadav

    Uploaded by

    riturawat19945
    8 views1 page

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    8 views1 page

    Adarsh Yadav

    Uploaded by

    riturawat19945

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    © All Rights Reserved
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    of 1

    सं.

    1 मय देश सरकार प-5


    NO. 1 GOVERNMENT OF MADHYA PRADESH FORM-5
    योजना, आिथक एवं सांियक वभाग
    DEPARTMENT OF PLANNING, ECONOMICS & STATISTICS
    संजय गांधी मेडकल अपताल, रवा
    SANJAY GANDHI MEDICAL HOSPITAL REWA

    जम माण-प
    BIRTH CERTIFICATE

    (जम मृयु रिजकरण अधनयम, 1969 क धारा 12 / 17 तथा मय देश 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 MADHYA PRADESH
    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 संजय गांधी मेडकल अपताल, रवा तहसील हुज़ूर िजला रवा
    राय/संघ देश मय 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 SANJAY GANDHI MEDICAL HOSPITAL REWA OF TAHSIL/BLOCK HUZUR OF DISTRICT REWA OF STATE/UNION TERRITORY MADHYA PRADESH,
    INDIA.

    नाम / NAME: ADARSH YADAV लंग / SEX: पुरष / MALE

    जम तथ / DATE OF BIRTH:


    जम थान/ PLACE OF BIRTH:
    02-08-2023
    SANJAY GANDHI MEDICAL HOSPITAL REWA
    SECOND-AUGUST-TWO THOUSAND TWENTY THREE

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


    KSHAMA YADAV LALJI YADAV

    आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
    XXXXXXXX2927
    XXXXXXXX6770

    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:

    BHUSUDI, , GURH, REWA, MADHYA PRADESH BHUSUDI, GURH, REWA,


    MADHYA PRADESH

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


    B-2023: 23-90516-005733 03-08-2023

    टपणी / REMARKS (IF ANY):


    2022883365011

    जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
    03-08-2023
    रिजार (जम एवं मृयु)
    REGISTRAR (BIRTH & DEATH)
    संजय गांधी मेडकल अपताल, रवा
    SANJAY GANDHI MEDICAL HOSPITAL REWA

    UPDATED ON :
    03-08-2023 08:23:12

    "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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