Key No.

B0080209-2012312
FORM No.5
(See Rule 8)
tIcf kÀ¡mÀ
GOVERNMENT OF KERALA
\KcImcy hIp¸v
DEPARTMENT OF URBAN AFFAIRS
kÀ«n^n¡äv \ðIp¶ Xt±iØm]\¯nsâ t]cv s]cn´ða® ap\nkn¸menÁn
Name of Local Government issuing certificate Perinthalmanna Municipality
P\\ kÀ«n^n¡äv
BIRTH CERTIFICATE
(Issued Under Section 12)

(1969þse P\\þacW cPnkvt{Sj³ BIvSnse 12þmw hIp¸pw 1999þse tIcf P\\þacW cPnkvt{Sj³ N«§fnse 8þmw
N«hpw A\pkcn¨v \ðIp¶Xv).
(Issued under Section 12 of the Registration of Births and Deaths Acts, 1969 and Rule 8 of the Kerala Registration of Births and Deaths
Rules, 1999)
Xmsg ]dbp¶ hnhc§Ä tIcf kwØm\¯nse ae¸pdw Pnñbnse s]cn´ða® Xmeq¡nse s]cn´ða®
ap\nkn¸menÁn þse (Xt±iØm]\w) AÊð P\\ cPnÌdnð \n¶v FSp¯n«pÅhbmsW¶v km£ys¸Sp¯p¶p.
This is to certify that the following information has been taken from the original record of birth which is the register for (local area/local
body) Perinthalmanna Municipality of Taluk Perinthalmanna of District Malappuram of State Kerala.
---t]cv/ Name : Bt_ð Bs³dWn / AABEL ANTONY
---B¬/s]¬/ Sex B¬/ Male
:
---P\\ XobXn/ Date of Birth : 30/12/2020
THIRTY/DECEMBER/TWO THOUSAND TWENTY
---P\\ Øew/ Place of Birth :
cmwZmkv ¢n\nIv Bâv \gvknwKv tlmw, s]cn´ða®/

RAMDAS CLINIC AND NURSING HOME, PERINTHALMANNA

---amXmhnsâ t]cv / Name of Mother
---]nXmhnsâ t]cv/ Name of Father
Ip«nbpsS P\\ kab¯v
amXm]nXm¡fpsS taðhnemkw
Address of the parents at the time of
birth of the child
/ SUKANYA
:
: jntâm tPmk^v / SHINTO JOSEPH
: Ipt¶ð ssIXaäw (lukv), ]met¨mSv (]n. H.), Ipf¯qÀ (hgn), ae¸pdw,
tIcfw, C³Uy
: KUNNEL KAITHAMATTAM (HOUSE), PALACHODE (P. O.), KULATHUR
(VIA), Malappuram, Kerala, India

amXm]nXm¡fpsS Øncamb : Ipt¶ð ssIXaäw (lukv), ]met¨mSv (]n. H.), Ipf¯qÀ (hgn), ae¸pdw,
taðhnemkw tIcfw, C³Uy

Permanent address of parents : KUNNEL KAITHAMATTAM (HOUSE), PALACHODE (P. O.), KULATHUR
(VIA), Malappuram, Kerala, India

cPnkvt{Sj³ \¼À/ : 145/2021 cPnkvt{Sj³ XobXn/ : 07/01/2021

Registration Number Date of Registration
---A`n{]mb¡pdn¸v/ Remarks (if any) :

---\ðIp¶ XobXn/ Date of Issue : 03/03/2023 (12:12) Last Updated on 08/01/2021 (12:25)

\ðIp¶ A[nImcnbpsS taðhnemkw/

: Registrar of Births and Deaths ,
Address of the issuing authority
Perinthalmanna Municipality

“Ensure Registration of Every birth and death”

“Hmtcm P\\hpw acWhpw cPnÌÀ sNbvXpsh¶v Dd¸phcp¯pI”
This certificate is computer generated and does not require any Seal/Signature in original
The Govt. vide G.O.(Ms) No.202/2012/LSGD dated 25/07/2012 has approved this certificate as a valid document for all official purposes
Authenticity of this certificate can be verified at www.cr.lsgkerala.gov.in. The Key Number is unique to each event.
Software developed and supported by Information Kerala Mission.
Certificate printed before the last updated date is invalid
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