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Birth Certificate: Government of Uttar Pradesh

This document is a birth certificate issued by the Nagar Nigam Lucknow Zone 3 in Uttar Pradesh, India. It certifies the birth of Srija Srivastava, born female on October 27, 2018 in Lucknow, Uttar Pradesh to parents NIHARIKA SRIVASTAVA and ASHUTOSH SRIVASTAVA. The certificate provides details of the child and parents such as their names, addresses and registration number and date. It states that the information has been taken from the original birth record registered with Nagar Nigam Lucknow Zone 3.

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4K views1 page

Birth Certificate: Government of Uttar Pradesh

This document is a birth certificate issued by the Nagar Nigam Lucknow Zone 3 in Uttar Pradesh, India. It certifies the birth of Srija Srivastava, born female on October 27, 2018 in Lucknow, Uttar Pradesh to parents NIHARIKA SRIVASTAVA and ASHUTOSH SRIVASTAVA. The certificate provides details of the child and parents such as their names, addresses and registration number and date. It states that the information has been taken from the original birth record registered with Nagar Nigam Lucknow Zone 3.

Uploaded by

Psyuni India
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
नगर नगम लखनऊ े 3
NAGAR NIGAM LUCKNOW ZONE 3

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 सुचना जम के मूल अभलेख से ल गई है जो क नगर नगम लखनऊ े 3 तहसील लखनऊ िजला लखनऊ 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
NAGAR NIGAM LUCKNOW ZONE 3 OF TAHSIL/BLOCK LUCKNOW OF DISTRICT LUCKNOW OF STATE/UNION TERRITORY UTTAR PRADESH, INDIA.

नाम / NAME: SRIJA SRIVASTAVA लंग / SEX: महला / FEMALE

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


27-10-2018 L-1/3, SEC-B,ALIGANJ,
TWENTY-SEVENTH-OCTOBER-TWO THOUSAND EIGHTEEN LUCKNOW,LUCKNOW, LUCKNOW,
UTTAR PRADESH

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


NIHARIKA SRIVASTAVA ASHUTOSH SRIVASTAVA

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

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
BIRTH OF THE CHILD: PARENTS:

LUCKNOW, , LUCKNOW, LUCKNOW, UTTAR PRADESH


LUCKNOW, LUCKNOW, LUCKNOW,
UTTAR PRADESH

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


B-2020: 9-91808-010673 25-10-2020

टपणी / REMARKS (IF ANY):


UMESH

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
25-10-2020
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
नगर नगम लखनऊ े 3
NAGAR NIGAM LUCKNOW ZONE 3

UPDATED ON :
25-10-2020 00:00:00

"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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