H4T 5
S.No. 1 GOVERNMENT OF MAHARASHTRA FORM5
GHHÍC51
DEPARTMENT OF HEALTH
C MUNICIPALITY YAVATMAL
BIRTH CERTIFICATE
(ISSUED UNDER SECTION 12/17OF THE REGISTRATION OF BIRTHS & DEATHS ACT. 1969AND RULE 8/13 OF THE MAHARASHTRA
REGISTRATION OF BIRTHS & DEATHS RULES 2000)
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WH IS
THE REGISTER FOR MUNICIPALITY YAVATMAL OF TAHSIL/BLOCK YAVATMAL OF DISTRICT YAVATMAL OF STATE/UNION
TERRITORYOF MAHARASHTRA, INDIA.
SHENDE/HAfasuas
NAME/T: SACHINVISHNU SEX/ feUT:
MALE/yT
AADHARNUMBER/3Tr GT: XXXXXXXX2669
DATEOF BIRTH/JrH RT: PLACEOF BIRTH/oH foA]UT:
30-12-1989 WANJARIFAIL, YAVATMAL, YAVATMAL, MAHARASHTRA,
THIRTIETH-DECEMBER-NINETEEN-EIGHTY-NINE /d
445001 445001
be, YddHIO,YdcHlo, HERISE,
NAMEOF MOTHER/
35 q GTT: NAMEOFFATHER/steie qt a:
/T S
CHAYASHENDE VISHNUSHENDE/fasuts
AADHARNUMBEROF MOTHER/3TETT
hHG: AADHARNUMBEROF MOTHER/3TTK ShHGE:
ADDRESS OF PARENTS AT THE TIME OF BIRTH OF THE
PERMANENTADDRESSOF PARENTS/ 31IS-sIiT AT YT:
WANJARIFAIL, YAVATMAL, YAVATMAL, MAHARASHTRA,
WANJARI
FAIL, YAVATMAL, YAVATMAL, MAHARASHTRA,
/ do h,
445001 yddHlo, ddHlo, HERISE,445001
445001
/d 445001
h, 4dGHIo,YAdHIS,HEIRISg,
NUMBER/cu
REGISTRATION hGE: DATEOFREGISTRATION
/iuîr fi#:
85789 12-01-1989
REMARKS(IF ANY) /ART(GR3RG ):
DATEOFISSUE/yHIUTYTrT fca6:
08-01-2025
Updated On: 08-01-2025
11:11:25
SIGNATURE
OFISSUING
AUTHORITY
/afr RunRIfaari
This QR codecan
be usedto checkthe authenticity of the Registrar (BIRTH & DEATH)
certificate'
MUNICIPALITY YAVATMAL
OFEVERYBIRTHANDDEATH/
'ENSUREREGISTRATION ot 3TOTH ycal ace GT"
