GuGIEBT Glesrmsr uTIG6|TLA

GREATER CHENNAI cORPORATiON

Aurgi &6TSTT`JIenp B5575555171C6297475/2023
DEPARTMENT OF PUBLIC HEALTH
FORM-NO.5,uignh neTS
(See rue 8-dg 8gi ures

|BIRTH CERTIFICATE / Slpiy sT6 D59

((SSUED UNDER SECTION 12/17 OF REGISTRATIONOF BIRTH AND DEATHACT 1969
a y ugy oLD
This is to
1969-sirifiy 1217-ir aj psiuiL0
certity that the
fo lowing information has been taken from the oniginal record of birth of the Greater
Chennal
Corporation of the State of Tamil Nadu, India
ihaem psatsdt súysro. ugsar arsiaar uarsam.A asa pis ugtariy Mgás «©åsiulLeai nar o7g
aagauaingan
Zone 05
Division 072
Name KUSHAGRA SINGH
Sex Male

Date of Birth 27-JUL-2011

Name of The Mother SHLESHA SINGH

Name of The Father PARIMAL SINHA

ROAD NO 6, RAJIV NAGAR KESARI NAGAR PO PATNA

Address ot Parents at the time of
Birth of The Child
BIHAR -800024

Place of Birth PRASHANTH HOSPITAL 77, HARRINGTON ROAD, CHETPET

CHENNAI-600031

Permanent Address Of the Parents ROAD NO 5, RAJIV NAGAR RESARI NAGAR PO, PATNA
BIHAR -800024

Registration Number cOc/2011/05/072/001756/0

Date of Registration 02-AUG-2011

Remarks 02JAN-2023
Date of Issue 02-JAN-2023

DR.M.Jagadeesan
Hen cer
Greater Chennal Corporatonn

E n s d k e g i S a t o n of every Birh and Death/ D n u H ' B D U H u y o l m T L D l e u d j

Note: This cerificale is computer generated and does not require any Seal/Signature in original
Tha authenticity of this certlicate can be verified at www.chennaicorporation gov in. The Registration Number is unique to
each birth.