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SHIVKUMAR

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972 views1 page

SHIVKUMAR

Uploaded by

itsme26746
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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థ෩ච§° Form - 5

ఒකბజఒళ౽ბబ

GOVERNMENT OF KARNATAKA

ఙథథపൡ౨పబఠఔయ෨ఓ౲ඣైంణ൏ඌ౽คఔำ
Chief Registrar of Births and Deaths
ఙథథద౳෥ఠదడ౳
‡ఙపඣైఄඌඛఫప~¬´±´బ¬­Ž¬²ඡఫద౳ఒబఠ๻ಟఒఙపඣైඛఫపఔำ~
¬´´´బඛఫప³Ž¬®బ෬ฉಡಆఞมణˆ
BIRTH CERTIFICATE
(Issued Under Section 12/17 of the RBDAct, 1969 and Rule 8/13 of the KRBD Rules, 1999)
7l_B2NĻ`\žl[UhÇB£eLBªeIÍSİsSŝĝ¬lÐ[İsS\Ÿe^iÐĔUİsS\ ľ<2ľ  ’eÎZVL¾P Sĸĝc¾ĸUĹÐ\h`IUU
c2X2T®eSZi^¡eC¬lĵ2SŸl’lShli_ѬeĖ¡lĶ2SVΨeĥsBĸc¬eĖ¡l
This is to certify that the following information has been taken from the original record of birth which is the register for Bidar
(CMC + OG) (village/town) of Bidar taluk of Bidar district of Karnataka State
 ²lc\h  ĹxD ²lPhÂ
Name SHIVKUMAR Sex male
 IUU®eSŸeĸsCh  IUU®eScÄ_ RAJESHWARI MEMORIAL HOSPITAL,
08/06/20012 BIDAR, BIDAR, BIDAR, Bidar (CMC +
Date of Birth Place of Birth OG),Bidar ,Bidar,Karnataka
 Ÿeĵ[²lc\h  Qx¡l[²lc\h
Name of Mother MAHADEVI Name of Father SANTOSH

 ZDhĻUIUUScZ[SĹÐQx¡lŸeĵ[\Ļ­ec  Qx¡lŸeĵ[\‘e[xĻ­ec

İsS\ ľ<2ľ İsS\İsSŝB£eLB İsS\ ľ<2ľ İsS\İsSŝB£eLB


Address of parents at the time of birth of the child: Permanent address of parents:
R/O BIDAR, Bidar (CMC + OG),Bidar ,Bidar,Karnataka H.NO.BAGDAL THANDA,BAGDAL, BIDAR,Bidar (CMC + OG),Bidar
,Bidar,Karnataka
 £lisxSĥcx‘lÍ  £lisxSĥŸeĸsCh 21/08/2023
803178/U/B/2012/002011
Registration No.: Date of Registration:
OLD REG NO
 bªe ©e`ƒ¡eT\h6SÅĹÐ 28/08/2023
8452
Remarks(if any) Date of Approval
 7VΨePVQÎ`ƒĻShÍ£eÌUcĿ[UhDzli2ĨShŐltX\dScĿ  VΨePVQΐliNh`¤eÎĩeĸ[Ļ­ec
4DQÍĻ^Ð Address of the issuing authority Health Inspector/Officer
Digitally signed certificate,manual signature is not required.
Bidar (CMC + OG), Bidar Taluk, Bidar District

Date of Issue 28/08/2023

”ద౳ൟ෽ంൿఙథథపൡ౨పబఠణඣైంణ൐ఫඝ౬ఓ೉డదല๭ಆั౶ •
³Ensure registration of every birth and death´
లฃ€ఙథథඣైంణ൐ఫඝ౬https://ejanma.karnataka.gov.in ణย౵ඁുైఒค๭ಆั౶
Note: Verify the Birth registration at https://ejanma.karnataka.gov.in

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