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Adobe Scan 15 Jul 2024 (1)

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33 views1 page

Adobe Scan 15 Jul 2024 (1)

Uploaded by

naikkomal499
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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VHU4A hHTE /Certificate No.

4AT - /Form -5
HRTg eRTol
GOVERNMENT OF MAHARASHTRA
HEALTH DEPARTMENT
yHTUrga frffua RUTTernfts gTà T4 Name of local body issuing
certificates

BIRTH CERTIFICATE

(ssued under section 12/17 of the Registration of Births &Deaths Aot, 1969 and Rule 8/13 of the
Maharashtra Registration of Births and Deaths Rules, 2000.)

,Gtlqeal

This is to certify that the following information. has been taken from the originalrecord of birth which is
the registerfor (local area/ local body) - -of tahsil /block
of District of MaharashtraState.
f:
Name of Child: Sex:

Date of Birth r0 Ezy Place of birth :

Name of Mother: Name of Father :

Address of Parents at the time of Birth of the Child : Permanent address of Parents :

aizuft fai:
Date of Registration :
Registration No. :
Signature &Stamp of the issuing authority
Remarks (If any):
Address of the issuing authority :
Date of issue:
fyrgeal/Seal

"Ensure Registation of every birth & death"

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