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Civil Registration System

This document is an official birth certificate issued by the Government of Uttar Pradesh for Ishika. It summarizes the key details of her birth including her name, sex, date of birth, place of birth, names of her parents and their address. The certificate was issued on December 26, 2023 by the Registrar of Births and Deaths of Nagar Nigam Zone 3 Kanpur Nagar and contains the facsimile signature of the issuing authority.

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Shyam Silver Director
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106 views

Civil Registration System

This document is an official birth certificate issued by the Government of Uttar Pradesh for Ishika. It summarizes the key details of her birth including her name, sex, date of birth, place of birth, names of her parents and their address. The certificate was issued on December 26, 2023 by the Registrar of Births and Deaths of Nagar Nigam Zone 3 Kanpur Nagar and contains the facsimile signature of the issuing authority.

Uploaded by

Shyam Silver Director
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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सं.

1 उर देश सरकार


NO. 1 GOVERNMENT OF UTTAR PRADESH
प-5
चकसा एवं वाय वभाग FORM-5
DEPARTMENT OF MEDICAL AND HEALTH
नगर नगम जोन ३ कानपूर नगर
NAGAR NIGAM ZONE 3 KANPUR NAGAR

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 नगर नगम जोन ३ कानपूर नगर तहसील कानपुर िजला कानपुर
नगर 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 ZONE 3 KANPUR NAGAR OF TAHSIL/BLOCK KANPUR OF DISTRICT KANPUR NAGAR OF STATE/UNION TERRITORY UTTAR
PRADESH, INDIA.

नाम / NAME: ISHIKA लंग / SEX: महला / FEMALE

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


09-07-2023 GOPAL KRISHNA HOSPITAL ,
NINTH-JULY-TWO THOUSAND TWENTY THREE KANPUR,KANPUR , KANPUR NAGAR,
UTTAR PRADESH

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


SHILPI ABHIJEET DUBEY

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 माता-पता के थायी पता/ PERMANENT ADDRESS OF PARENTS:
TIME OF BIRTH OF THE CHILD:
84/11 BLOCK NO-9 GOVIND NAGAR , 84/11 BLOCK NO-9 GOVIND NAGAR,
KANPUR, , KANPUR , KANPUR NAGAR, UTTAR PRADESH KANPUR, KANPUR , KANPUR NAGAR,
UTTAR PRADESH

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


B-2023: 9-93820-002260 03-11-2023

टपणी / REMARKS (IF ANY):


1488/2-11-23

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
26-12-2023
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
नगर नगम जोन ३ कानपूर नगर
NAGAR NIGAM ZONE 3 KANPUR NAGAR

UPDATED ON :
26-12-2023 05:53:03

"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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