$sU’-1 FORM - 5

Ȥ¸å€lS 5€kl€
GOVERNMENT OF GUJARAT
8€s³7 KW` X¢€Gl€ kƣ7lR LGKlF
DEPARTMENT OF HEALTH AND FAMILY WELFARE

åoU ™UlRXt
BIRTH CERTIFICATE
(åa\ KW` \3R WҭtRj KßtßWJ\, Rs Wj ક\ Rz/R9 KW`

. Ȥ¸å3lS åa\-\3R WҭtRj ßWJ\h , zORSWl ßWJ\ - S fl¸åG)

(Issued under Section 12/17 of the Registration of Birth and Death Act,1969 and
Rule 8 of the Gujarat Registration of Birth and Deaths Rules 2018)

8Rj ™\lRjS ક 3Gl\l˙ 8G` 9` ક`, WjI`Wj \lł!Sj åa\Wl fl˛G 3`ક 3'\l˙Rj ”`Gl\l˙ 8Gj 9`. å [l3SWl Ȥ¸å3lS 3lBJWl å¸WlF6 łåƣ”l Wl å¸WlF6 Sl½¸ક lWl å¸WlF6
˴l\/b!`3Wl 3łåƨ33\l˙ 9`.
This is to certify that the following information has been taken from the original record of birth which is in the register for Village/City
Junagadh(C) of Taluka Junagadh(C) of District Junagadh of Gujarat State, India.

Wl\/Name : ƨG3l / SWARA åßS / Sex : \ṏH / Female

åa\ Sl3ŽN/Date of Birth : 03/11/2022 åa\ ƨRG/Place of Birth :

Thursday, November 3, 2022 G.M.E.R.S.( Civil Hospital,) Junagadh

\lSlA¸˙ Wl\/Name of Mother : ß1SlA¸˙ Wl\/Name of Father :

f5t˙Gl‫ ږ`ړ‬/ PRIYANKABEN !SS`bKl€ l˙GkloSKl€ llGSl / HITESHBHAI

CHANDRAKANTBHAI CHAVDA

GlG ક Wl åa\ 5\J` \lSl-ß1SlA¸˙ 53Wlfl¸˙/ Address of parents at the time \lSl - ß1SlA¸˙ ક lJ\j 53Wlfl¸˙ / Permanent Address of Parents :
of Birth of child :
JUNAGADH / ø¸‫ړ‬l‫ڍڂ‬ JUNAGADH /ø¸‫ړ‬l‫ڍڂ‬

WҭtRj h\l˙ક/Registration No. : 10954 WҭtRj Wj Sl3ŽN/Registration Date : 10/11/2022

3Ž\l ક'5 (ßGb`c Wҭt)/Remarks (if any) : ™\lR1t W˙G3/ Certificate No. : B202220920099
/0

™\lR1t ક l6Ž 8ƜJlWj Sl3ŽN / Date of issue : ™\lR1t 81Wl3 5Ălßt ક l3ŽWj 5!Ž/ Signature of Issuing
Authority :
16/11/2022 ..................................................................................

Sub Registrar ( Birth & Death )

5G €ГåƨŞl€ ( åoU & U€R)
Junagadh(C) , Junagadh

Disclaimer : This is a computer generated extract of birth register. In case of any objection, please contact concerned Registrar (B&D).
fK/1QQ1XZH6Ms5MBKs/6Kp79vXj16w3umLL5sSB9wMj0weLnzjidtIXgl5ijOjdX