Ys\½}FORM - 5
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GOVERNMENT OF GUJARAT
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DEPARTMENT OF HEALTH AND FAMILY WELFARE
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BIRTH CERTIFICATE
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. ȤkK^hSKƛ\\^RWҭVRjiW]\szxyWhiW]\ȺkKZ
(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)
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aPsU^hShɀkDhWhbj]hZhF˴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
SIYABAUG - North Zone of Taluka Vadodara(C) of District Vadodara of Gujarat State, India.
Wh\Name : i\ƧNMISHTI ĤiSSex : ḚṏڦMale
Kƛ\Sh^EDate of Birth : 25/02/2024 Kƛ\ƨT`Place of Birth :
Sunday, February 25, 2024 SIR SAYAJIRAO GENERAL HOSPITAL VADODARA
\hShȵk5Wh\Name of Mother : iXShȵk5Wh\Name of Father :
ڤڟڝ᷷VARSHA iWE_Ȣk\h^[h^̃ahKNIKHILKUMAR BHARIDRVAJ
Zh`DWhKƛ\d\]p\hShiXShȵk5d^WhȺk5Address of parents \hShiXShȵk5Dh]\jd^WhȺk5Permanent Address of
at the time of Birth of child : Parents :
31,VITHHAL NAGAR NEAR PANCHSIL MANEJA VADODARA 31,VITHHAL NAGAR NEAR PANCHSIL MANEJA VADODARA
/ ڝڥڵڷḅڬڎڤژڬڠڤڔڛڦڞڅٱڔښڂړڛڋἒڤښڑگڌڝ ڝڥڵڷḅڬڎڤژڬڠڤڔڛڦڞڅٱڔښڂړڛڋἒڤښڑگڌڝ
WҭVRj˲\h5DRegistration No. : 1002 WҭVRjWjSh^ERegistration Date : 20/03/2024
^\hD½d iabpcWҭV Remarks (if any) : ̆\hRX́W5Z^Certificate No. : B202420237177
/0
̆\hRX́DhQ8Ɯ]hWjSh^EDate of issue : ̆\hRX́8XWh^dĂhiVDh^WjdeSignature of Issuing
Authority :
20/03/2024 ..................................................................................
Sub Registrar ( Birth & Death )
dZ^Kƨ˼h^ Kƛ\\^R
SIYABAUG - North Zone , Vadodara
..
Disclaimer : This is a computer generated extract of birth register. In case of any objection, please contact concerned Registrar (B&D).
/CH+XzY3cimJPFsNnG4YKr7Sm1ZJtBHiIVA02r06BVsClH14oqOnHVAwgb43cp/T
