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RITIKA

This document is a birth certificate issued by the Government of Uttar Pradesh for a child named Ritika, born on October 12, 2012, in Palhipur, Rae Bareli. It includes details about the child's parents, their Aadhaar numbers, and addresses at the time of birth. The certificate is issued under the Registration of Births & Deaths Act, 1969, and is recognized as a valid legal document for official purposes.

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KARAN KHURANA
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38 views1 page

RITIKA

This document is a birth certificate issued by the Government of Uttar Pradesh for a child named Ritika, born on October 12, 2012, in Palhipur, Rae Bareli. It includes details about the child's parents, their Aadhaar numbers, and addresses at the time of birth. The certificate is issued under the Registration of Births & Deaths Act, 1969, and is recognized as a valid legal document for official purposes.

Uploaded by

KARAN KHURANA
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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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
ाम पंचायत पलहपुर
GRAMA PANCHAYAT PALHIPUR

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 ाम पंचायत पलहपुर तहसील सलौन िजला रायबरेल 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 GRAMA PANCHAYAT PALHIPUR OF TAHSIL/BLOCK SALON OF DISTRICT RAE BARELI OF STATE/UNION TERRITORY UTTAR PRADESH, INDIA.

नाम / NAME: RITIKA लंग / SEX: महला / FEMALE

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


12-10-2012
TWELFTH-OCTOBER-TWO THOUSAND TWELVE PALHIPUR,SALON, RAE BARELI,
UTTAR PRADESH

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


REENA VIRENDRA

आधार नंबर / MOTHER'S AADHAAR NO: आधार नंबर / FATHER'S AADHAAR NO:
XXXXXXXX2476
XXXXXXXX2138

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: PURAB GAON POST - SAIRPUR BAKSHI KA TALAB LUCONOW
PURAB GAON POST - SAIRPUR BAKSHI KA TALAB LUCONOW UTTAR PRADESH UTTAR PRADESH

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


B -2024: 9-46741- 003167 25-07-2013

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY :
11-05-2024
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
ाम पंचायत पलहपुर
GRAMA PANCHAYAT PALHIPUR

UPDATED ON :
11-05-2024 16:42:04

"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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