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    This birth certificate provides information about Anish Kumar Das born on July 3, 1995 in Bhopal, Madhya Pradesh, India. His parents are named as Madhavi Das and ChittaRanjan Das, who resided in Bhopal at the time of his birth. Their permanent address is listed as Gaon Chhota Sangra Teh. Suri, Birbhumi, West Bengal. The registration number for this birth certificate is 000000001198 and it was issued on February 12, 2015 by the Assistant Registrar based on information from the original record at the Municipal Corporation, Bhopal registration office.

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    IMG_20150813_0003

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    This birth certificate provides information about Anish Kumar Das born on July 3, 1995 in Bhopal, Madhya Pradesh, India. His parents are named as Madhavi Das and ChittaRanjan Das, who resided in Bhopal at the time of his birth. Their permanent address is listed as Gaon Chhota Sangra Teh. Suri, Birbhumi, West Bengal. The registration number for this birth certificate is 000000001198 and it was issued on February 12, 2015 by the Assistant Registrar based on information from the original record at the Municipal Corporation, Bhopal registration office.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    24 views1 page

    Img 20150813 0003

    Uploaded by

    Anish kumar das
    This birth certificate provides information about Anish Kumar Das born on July 3, 1995 in Bhopal, Madhya Pradesh, India. His parents are named as Madhavi Das and ChittaRanjan Das, who resided in Bhopal at the time of his birth. Their permanent address is listed as Gaon Chhota Sangra Teh. Suri, Birbhumi, West Bengal. The registration number for this birth certificate is 000000001198 and it was issued on February 12, 2015 by the Assistant Registrar based on information from the original record at the Municipal Corporation, Bhopal registration office.

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    © All Rights Reserved
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    of 1

    03111s002814n996(1) Form-5

    ffi
    qffi$q1ffiil
    GOVERNMENT OF MADHYA PRADESH
    frr+t, qtffifiWutmfiAtrr.r
    (Department of Planning Economics & Statistics)
    -*frWvirul*
    DIRECTORATE OF ECONOMICS AND STATISTICS
    sfqTqTTf-q-{
    BIRTH CERTIFICATE
    (w+-gq {Fr$fiw erf,*ftTs, I 969 fr artr I 2 / 1 7 dsn qgqqtn wq-{q {Crd-fi'rT ftqq, r 999
    hfiTq8 / 13 h3r.fli(qrftfrqrrrqr) - -
    (lssued under Section 12/17 of the Registration of Birth and Death Act. 1969 and Rule 8/13 of the
    Madhya Pradesh Registration of Births and Death Rules. 1999)

    ^rq rffir+ftvr^vmrft fr'f+erfrfua (T{r crFrr h qur tq tfr TS t s} fr(pil-;ft.q *{)


    trrr<ftq,q,*crq eqfi-'q 6g-( G-fl *Trq {rmr qETQff (qrce) h ffiF.( t- s€tB{ '{r
    This is to certifo that following information has been taken from the original record of birth
    which is the register for (local area / local body ) Municipal Corporation, Bhopal of tahsil Huzur of
    District Bhopal of State Madhyapradesh (INDIA).

    iT{ / Name - efftqf STff (RI / Anish Kumar Das

    ftir-/Sex- SFs/Male. q;q ftfr /Dateof Birth -03.07.1995 q;q Fqr+/placeof Birrh - *crqlBhopal.

    qril sr rrq / Name of Mother - qrrff (RI / Madhavi Das .

    ft-6m1aq/Name of Father - fttrf tWfifff t ChittaRanjan Das .

    qd h wq + H-rr?r qril frer w rm I qmr fterw e+rfi.rm I


    Address of parents at the time of birth of the child - Permanent address of parcnts -
    ,., *.*.q. t-e<. uiaeirarftr<rilq-fiq$'.
    fr.Trq,qoso./ +qfr,+€d-{nq.
    03, E. M. E. Center. Gaon Chhota Sangra Teh. Suri.
    Bhopal,M.P. Birbhumi,W.8..
    qfrfiq- +qr / Registration No. 000000001 198 qfi-rwrffif /Date of Registration -31.12.1996

    ftFquft / Remark (if a.ny ), - {ien : ftffi 3rctkflrr frcrm I Institute : MILITARy HospITAL BHOPAL .

    qrft m-G fi frft / Date of issue - 12.02.2015 srtffih Signature of the issuing authorify

    fiBsrft 6'T tkIT / Address of the issuing authority

    ,,EnSureregistrationofeverybirthand,,".R,M$Ef,s6q;,,,

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