‘BMPP-15403-2012-19-6,00,000 Puzo? MUNICIPAL CORPORATION OF GREATER MUMBAI gesiad errant t Date Address to. To ‘The Executive Health Officer, verter’ aria afer, To be submitted at the Ward Oifice of the respective Medical Officer of Health, ‘dafaa deat after, acter, aton fear aprateraia argt ae, f Please furnish me with ... Copy/Copies of Birth Registry Certificate. The Particulars are seer ror eat s/s ene oa eo, een ee ete om FullNNames of Parents. ) Father : y aii ont-adietst at Mather ane Residential place of parents in ‘Mumbai at the time of birth as furnished for birthregistration ae Ifthe birth took place in Hospital the name of the Hospital eran ort srafergere ia. fet BEM sre Ta Child's Name 80K spatter Had ene ata Date of birth. Enclosed fee Rupees vad yee ie teat i Ihave read and agree tothe conditions printed onthe reverse. ter anger wren ch heer are een Wen FET At Name of the applicant in Block Letters : .. SpRTTa apt ata (Saw sR) Signature. wet ero) (pon mtTo BEFILLEDINBY THE OFFICE peter more rake} rear att. Called OM nnn ‘atenfacara fies DSL cents NO: sraeeeynenn “ Fee Rs. ‘fei wad nia RRS. Issuing B.C. NO. cnn oe on Search Period £ Quer don-an oraicot serorrarar aE sear aI HG. CONDITIONS: at: 4. Cortificates will be prepared as per the original Municipal Records. rere ps archaea TOM ea rE et. 2. Fresh fees willbe necessary for modified copy after complying with the procedure laid down in this behall. “gareon aevaniehh arated arene ogee, eas er re arrears arene a AHH Bo SAH oT 3. Certificate willbe delivered on production of receipt only. Wad Bret Saemraee BATON want act. 4, Noclaim for refund, certificate, or otherwise willbe entertained 6 months after the date of payment. a rea & Hlearieg, FA wet wee, wero 3 fe eae Bree ASR eh Fara eet SME ATE 6. _ Refundif any, admissible will be paid only to the applicant on production of the receipt fara mea areca, (oR arate az), a (his) signers we wee Freee carews Boar Veer.