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Document Sr, No
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Srfr)td/D.P.H - 368
tfrrqfrArtl/ Government of Puniab
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Heallh an! Family Welfage_Depprtment
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Chief Registrar Births and Deaths, Punjab
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ErilH/ Form-6
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2017 e dlTIFle f€tl eclrl d I

This is to certify that following information has been taken from the original birth record which is regi
in the birth register of Local Registrar, Births and Deaths, Municipal Corporation / Council Mu
Committee, Barnala, Tehsil Barnala District Barnala of Punjab State for the year 2017.

6rH / Name: TTfufiTWJASINDER SINGH

ffidt / sex: IIilII/Male
lrf3re,6rlt/ Father,s Name: EfdrFffi,#CUnpREET STNGH
d E a-r / Grand Father's Name:[rI#J fHut lsun;lT SINGH
HBeI6rll/ Mother's Name: UflfrSddHARpREET KAUR
t-6.H fii / Date of Birth: 13-Oct-2005 Tf6H lrfHE[rd
/ Place of Birth : rkfiSESI /
BARNALA
dhFralrrd 6sd / Resistration 054/80 O2B1t2O17lO9994OafuFelF6 d flri I
No : Date of Registration : 05-Apr-2017

riiltraxrAyErfu3reTqT HExflExerqar€r
Address of Parents at the time of birth of the child Permanent Address of parents
rrc.6847dqfi€t?Figdr.dt 1 trirarsr/HousE No 47 rq'at47frafr€rg'tJdrridt 1 tnr6r{F
THIKRIWALA ROAD STREET NO 1 BARNALA /HOUSE NO 47 THIKRIWALA ROAD STREET
NO 1 BARNALA
Date of lssuance : 05-Apr-2017 Signature of the lssuing Authority:
Digitally Signed by:
Gurdarshan Singh
Designation : Local Registrar/ EOMG
(Stamp and sign of certificate printing center) Date: 05-Apr-2017
Location Municipal Gomm ittee, Barnala
Remark - Approved
:

/Barnala

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- fssued uis 12l17oflhe Registration of Births and Deaths Act, 1969 and rules 8/13 the Punjab Registration of Births and Deaths Rules 2004.

laimef - "This is a digitally Signed Certificate and does not require hand written signatures. The responsibility of verification of this document,
before accepting the same for any- legal purpose, would rest with the lnstitution or Organization or Company or any other entity
where this document is produced.'
The Content of this document could be verified using the document serial number at the following web link
http://edistrict. punjab. gov. in/

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