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The document is a birth certificate for a girl named Ann Gupta born on 30 April 2024 at the Community Health Centre Pipra Daulakadam in Deoria, Uttar Pradesh, India. It provides information like the names and addresses of the parents and registration details.

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22 views

MPDF

The document is a birth certificate for a girl named Ann Gupta born on 30 April 2024 at the Community Health Centre Pipra Daulakadam in Deoria, Uttar Pradesh, India. It provides information like the names and addresses of the parents and registration details.

Uploaded by

HARI DIGITAL POINT
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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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
सामुदायक वाय क पपरा दौलकदम
COMMUNITY HEALTH CENTRE PIPRA DAULAKADAM

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 सामुदायक वाय क पपरा दौलकदम तहसील देवरया िजला देवरया
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
COMMUNITY HEALTH CENTRE PIPRA DAULAKADAM OF TAHSIL/BLOCK DEORIA OF DISTRICT DEORIA OF STATE/UNION TERRITORY UTTAR PRADESH,
INDIA.

नाम / NAME: ANNU GUPTA / अनू गुा लंग / SEX: महला / FEMALE

जम तथ / DATE OF BIRTH:


जम थान/ PLACE OF BIRTH:
30-04-2024
CHC PIPRA DAULAKADAM/सामुदायक वाय क पपरा दौलकदम
THIRTIETH-APRIL-TWO THOUSAND TWENTY FOUR

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


RAGINI DEVI / रागनी देवी HARIGOVINDA GUPTA / हरगोवंद गुा

आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
XXXXXXXX6172
XXXXXXXX8348

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:
BARAWAMIR CHHAPAR , BARAWAMIR CHHAPAR,
DESAHI DEORIA, BARWAMIR CHHAPAR, DEORIA, DEORIA, DESAHI DEORIA, BARWAMIR CHHAPAR, DEORIA, DEORIA,
UTTAR PRADESH UTTAR PRADESH
बरवामीर छापर , बरवामीर छापर,
देसह देवरया , बरवामीर छापर , देवरया, देवरया, देसह देवरया, बरवामीर छापर , देवरया, देवरया,
उर देश उर देश

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


B-2024: 9-59361-000356 30-04-2024

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
30-04-2024
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
सामुदायक वाय क पपरा दौलकदम
COMMUNITY HEALTH CENTRE PIPRA DAULAKADAM

UPDATED ON :
30-04-2024 14:29:13

"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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