.

8Tj̆\hRjSD^ah\h58apJpD°WjIpWj\hˆeSjKƛ\WhȺl`^°DP½\h5Tj_pah\h58ajJpȐ[h^SWhȤkK^hS^hԌ]WhĤ\WF^‰Kƣ_hWh
Ĥ\WF^˴h\jRShɀkDhWhZh_5[PŽ˴h\be°^Wh^‰KƨN^\h5Jp

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
Balambhdi of Taluka Jamnagar Rural of District Jamnagar of Gujarat State, India.

Wh\Name : ἒ‫ڬڌ‬ἒ‫ڤږڧڞڑ‬Jadeja Dashuba ĤiSSex : Ḛṏ‫ڦ‬Female

Kƛ\Sh^ŽEDate of Birth : 30/09/1975 Kƛ\ƨT`Place of Birth :

Tuesday, September 30, 1975 At. Balambhadi Ta. Jamnagar Dist. Jamnagar 361280
\hShȵk5Wh\Name of Mother : iXShȵk5Wh\Name of Father :

‫ڤږښڧڀړڤژ‬Mankurba eh_hĥ_ȴk[hahQ°^Halaji ladhubha vadher

Zh`DWhKƛ\d\]p\hShiXShȵk5d^WhȺk5Address of parents \hShiXShȵk5Dh]\jd^WhȺk5Permanent Address of

at the time of Birth of child : Parents :
At. BALAMBHADI TA. JAMNAGAR DIST. JAMNAGAR / Ⱥk At. BALAMBHADI TA. JAMNAGAR DIST. JAMNAGAR Ⱥk
Zh_5[PŽSh‰KĤ\WF^ Zh_5[PŽSh‰KĤ\WF^

WҭVRj˲\h5DRegistration No. : 24 WҭVRjWjSh^ŽERegistration Date : 30/09/1975

^Ž\hD½d iabpcWҭV Remarks (if any) : ̆\hRX́W5Z^Certificate No. : B197520003079

/
̆\hRX́DhQŽ8Ɯ]hWjSh^ŽEDate of issue : ̆\hRX́8XWh^dĂhiVDh^ŽWjdeŽSignature of Issuing
Authority :
11/10/2023 ..................................................................................

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