f Page 1 of 1 OFFICE OF THE GRAMPANCHAYAT Jangareddy Gudem Mandal zangareddy Gudem District WEST GODAVART Form 5 (See Rule 8) BIRTH CERTIFICATE mane (issued under Section 12/17 of the Registration of Births and Deaths Act, 1969.) This Is to certify that the following Information has been taken from the original record of birth which is in the Register of Local area Grampanchayat Jangareddy Gudem of Mandal Jangareddy Gudem of District WEST GODAVARI of State Andhra Pradesh of INDIA. Name : PEKETI. RUSHEE Sex Male Date of Birth : 20/04/2008 ‘Two Zero Zero Four Two Zero Zero Elght Place of Birth : NIRMALAHOSPITAL 1 H.No - 11-12/1 ELURU ROAD Jangareddy Gudem Grampanchayat Jangareddy Gudem Mandal 534447 Name of the Father : PEKETI JAYANANDA SATISH BABU Name of the Mother: PEKETI SUNEETA Registration No. 1693 Date of Registration 03/05/2008 Date:29/01/2011 we Raa peorsr nan Zul BIRTUS & DEATHS GRAM PANCHAYAT JANGAREDDYGUCEM. PANCHAYAT SECRETARY P.Jangareddy Gudem euyear=2008&msg=1&apno=.. 1/29/2011 ‘hup://epanchayat.ap.nic.in/bdsBirthCertiticate,jsp?eyno™693)