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SignedBirthCertificate 10022966 507

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137 views

SignedBirthCertificate 10022966 507

Uploaded by

rabiulsk1800
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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Form-5

GOVERNMENT OF WEST BENGAL


DEPARTMENT OF HEALTH AND FAMILY WELFARE

RURAL HOSPITAL BANGITOLA

BIRTH CERTIFICATE

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE WEST BENGAL
REGISTRATION OF BIRTHS & DEATHS RULES 2000.)

THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS
THE REGISTER FOR RURAL HOSPITAL BANGITOLA OF BLOCK/MUNICIPALITY KALIACHAK - II OF DISTRICT MALDA OF STATE
WEST BENGAL, INDIA.

NAME : HALIMA KHATUN GENDER : FEMALE

DATE OF BIRTH : 10/03/2024 PLACE OF BIRTH : PRIMARY HEALTH CENTRE MOTHABARI,


KALIACHAK - II, MALDA, WEST BENGAL

NAME OF MOTHER : ROHIMA BIBI NAME OF FATHER : MD HAMIM SEKH

MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX1332


XXXXXXXX2110

PRESENT ADDRESS OF MOTHER BLDG.NO & NAME:- CHAK PROTAPPUR ,STREET/LANE:- TITIHIPARA,LOCALITY:-
AT THE TIME BIRTH OF THE MOTHABARI,VILLAGE/TOWN:- CHAK PROTAPPUR,KALIACHAK - II BLOCK,DIST:- MALDA,WEST BENGAL-
CHILD : 732207

PERMANENT ADDRESS OF BLDG.NO & NAME:- CHAK PROTAPPUR ,STREET/LANE:- TITIHIPARA,LOCALITY:-


MOTHER : MOTHABARI,VILLAGE/TOWN:- CHAK PROTAPPUR,KALIACHAK - II BLOCK,DIST:- MALDA,WEST BENGAL-
732207

CERTIFICATE NO : B/2024/0585842 DATE OF REGISTRATION : 24/04/2024

S-UHID : 86677757428623 REMARKS (IF ANY) :

DATE OF ISSUE : 24/04/2024 UDIN : ----

UPDATED ON : 2024-03-22 14:57:11 ISSUING AUTHORITY :

Signature Not Verified


Digitally Signed.
Name: MOHAMMAD ADHIL AKTAR
Date: 24-Apr-2024 14:26:25

REGISTRAR (BIRTH & DEATH)


RURAL HOSPITAL BANGITOLA

"THIS IS A COMPUTER GENERATED CERTIFICATE."


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

"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH"

The QR Code and Certificate Number can be verified through the portal https://janma-mrityutathya.wb.gov.in

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