SOCIALIST REPUBLIC OF VIETNAM No.

: 58/2001
Independence – Freedom – Happiness Book No.: 01/2001

BIRTH CERTIFICATE
(ORIGINAL)

Full name : HOANG THI HUE Sex: Female

Date of birth : July 27th, 1999
Form TP/HT-2010-KS.1 10/2011(decision No: 08.a/2010/TT– BTP) XBTP

In words: The twenty seventh of June, nineteen ninety-nine

Place of birth : Do Son Medical Center
Ethnic group : Kinh Nationality: Vietnamese
Name of father : HOANG GIA MIEN
Ethnic group : Kinh Nationality: Vietnamese Year of birth: 1966
Resident/provisional address : Group 3, Van Huong, Do Son, Hai Phong
Name of mother : DOAN THI THU
Ethnic group : Kinh Nationality: Vietnamese Year of birth: 1973
Resident/provisional address : Group 3, Van Huong, Do Son, Hai Phong
Place of birth registration : People’s Committee of Van Huong Ward, Do Son, Hai Phong
Date of birth registration : August 30th, 2001
Note : People's Committee of Do Son District re-issued the original Birth Certificate on
August 9th, 2012
Full name of reporter: Hoang Gia Mien
Relation with birth certificate holder: Father

OFFICER SIGNING TO BIRTH CERTIFICATE

OFFICER PP. CHAIRMAN OF PEOPLE'S COMMITTEE OF
(signed) DO SON DISTRICT
Nguyen Thi Thu HEAD OF JUDICIAL DEPARTMENT
(Signed & sealed)
Vu Dinh Quang