Form No.

5
(See Rule 8)

BIRTH CERTIFICATE
Haryana Government
Health Department

Issued under Birth and Death Registration Act, 1969 under section 12/17

Certified the given information has been taken from Original Birth record of
(Local Area) Municipal Corporation Kaithal, District Kaithal, State Haryana, India.

Name : Vikas Garg Sex : Male

Date of Birth : 26-10-1991 Registration No. : 10938

Date of Registration : 04-11-1991

Place of Birth : Delhi, Haryana

Father's Name : Birbhan Garg

Mother's Name : Santosh Garg

Address of Father/Mother: H.No. 489 Sector 19, Huda Kaithal – 136027, Haryana

Date of Birth (in words) : Twenty Sixth October Nineteen Thousand Ninety One

Dated: 15-05-2024
Signature of Issuing Authority

Stamp

Above information is certified under the section 76 of Indian Evidence Act.