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RYDRTRT

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27 views1 page

RYDRTRT

Uploaded by

ali.vahid786
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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Key No.

B0070719-93010826115
FORM No.5
(See Rule 8)
tIcf kÀ¡mÀ
GOVERNMENT OF KERALA
]©mb¯v hIp¸v
DEPARTMENT OF PANCHAYAT
kÀ«n^n¡äv \ðIp¶ Xt±iØm]\¯nsâ t]cv Nqïð {Kma ]©mb¯v
Name of Local Government issuing certificate Choondal Grama Panchayat
P\\ kÀ«n^n¡äv
BIRTH CERTIFICATE
(Issued Under Section 12)

(1969þse P\\þacW cPnkvt{Sj³ BIvSnse 12þmw hIp¸pw 1999þse tIcf P\\þacW cPnkvt{Sj³ N«§fnse 8þmw
N«hpw A\pkcn¨v \ðIp¶Xv).
(Issued under Section 12 of the Registration of Births and Deaths Acts, 1969 and Rule 8 of the Kerala Registration of Births and Deaths
Rules, 1999)
Xmsg ]dbp¶ hnhc§Ä tIcf kwØm\¯nse XrÈqÀ Pnñbnse Xe¸nÅn Xmeq¡nse Nqïð {Kma ]©mb¯v þse
(Xt±iØm]\w) AÊð P\\ cPnÌdnð \n¶v FSp¯n«pÅhbmsW¶v km£ys¸Sp¯p¶p.
This is to certify that the following information has been taken from the original record of birth which is the register for (local area/local
body) Choondal Grama Panchayat of Taluk Thalappilly of District Thrissur of State Kerala.
---t]cv/ Name : t]cv cPnÌÀ sNbvXn«nñ / Name Not Registered
---B¬/s]¬/ Sex B¬/ Male
:
---P\\ XobXn/ Date of Birth : 31/12/1992
THIRTY ONE/DECEMBER/ONE THOUSAND NINE HUNDRED NINETY TWO
---P\\ Øew/ Place of Birth :
skâv tPmk^vkv tlmkv]näð Nqïð, Nqïð/

St.Joseph’s Hospital Choondal, Choondal


---amXmhnsâ t]cv / Name of Mother joe sI.hn. / Sheela K.V.
:
---]nXmhnsâ t]cv/ Name of Father
: tPmWn hn.H. / Johny V.O.
Ip«nbpsS P\\ kab¯v : *** e`yañ
amXm]nXm¡fpsS taðhnemkw

Address of the parents at the time of : *** Not Available


birth of the child
amXm]nXm¡fpsS Øncamb : hS¡q«v hoSv, ]mhd«n, XriqÀ, tIcfw, C³Uy
taðhnemkw

Permanent address of parents : Vadakkoott House, Pavaratty, Thrissur, Kerala, India

cPnkvt{Sj³ \¼À/ : 58/1993 cPnkvt{Sj³ XobXn/ : 08/01/1993


Registration Number Date of Registration
*** AÊð tcJIfnð Ip«nbpsS P\\ kab¯v amXm]nXm¡fpsS taðhnemks¯
---A`n{]mb¡pdn¸v/ Remarks (if any) : kw_Ôn¨ tImf§Ä DÄs¸Sp¶nñ

*** The original records do not contain the column relating to the address of the parents at
the time of birth of the child.
---\ðIp¶ XobXn/ Date of Issue : 04/03/2016 (08:53) Last Updated on 16/02/2015 (10:50)

\ðIp¶ A[nImcnbpsS taðhnemkw/


: Registrar of Births and Deaths ,
Address of the issuing authority
Choondal Grama Panchayat

“Ensure Registration of Every birth and death”


“Hmtcm P\\hpw acWhpw cPnÌÀ sNbvXpsh¶v Dd¸phcp¯pI”
This certificate is computer generated and does not require any Seal/Signature in original
The Govt. vide G.O.(Ms) No.202/2012/LSGD dated 25/07/2012 has approved this certificate as a valid document for all official purposes
Authenticity of this certificate can be verified at www.cr.lsgkerala.gov.in. The Key Number is unique to each event.
Software developed and supported by Information Kerala Mission.
Certificate printed before the last updated date is invalid
Page 1/1

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