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34 views

MPDF

Uploaded by

kislaya tripathi
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
नगर नगम जोन-४ अलापुर
NAGAR NIGAM ZONE-4 ALLAHAPUR

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-४ अलापुर तहसील इलाहाबाद िजला यागराज
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-4 ALLAHAPUR OF TAHSIL/BLOCK ALLAHABAD OF DISTRICT PRAYAGRAJ OF STATE/UNION TERRITORY UTTAR PRADESH,
INDIA.

नाम / NAME: MISIKA TRIPATHI लंग / SEX: महला / FEMALE

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


11-01-2019 192/1N/4B/1, TILAK NAGAR,
ELEVENTH-JANUARY-TWO THOUSAND NINETEEN ALLAHABAD,ALLAHABAD, PRAYAGRAJ,
UTTAR PRADESH, 211006

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


NITYA TRIPATHI DIPAK TRIPATHI

आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
XXXXXXXX8917

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:
192/1N/4B/1, TILAK NAGAR, 351, SALON,
ALLAHABAD, , ALLAHABAD, PRAYAGRAJ, UTTAR PRADESH- 211006 BAIRMPUR, AMETHI (NP), AMETHI , AMETHI,
UTTAR PRADESH- 227405

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


B-2023: 9-91761-001645 10-05-2023

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
10-05-2023
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
नगर नगम जोन-४ अलापुर
NAGAR NIGAM ZONE-4 ALLAHAPUR

UPDATED ON :
10-05-2023 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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