Government of Tamil Nadu

Ulg J 6T 600T. 5

(sl - 8 gú unis6)

Department of MunicipalAdministration & Water Supplyy

BIRTH CERTIFIÇAT (TRANSLATED VERSION)
ipuy ET60TMlE5P
Births and Deaths Act. 1969 and
(Issued Under Section 12/17 of the Registrationof
Rule 8 of Tamil Nadu Registration of Births and Deaths Rules 2000)
This is to Certify that the following information has been taken
from the original record of Birth which is the register for (Local Area)
Division (05 ), KOVILPATTI MUNICIPALITY of Taluk
THOOTHUKUDI
KOVILPATTI of District
of State TAMILNADU.

ipssodoT gsavssT giigpsr6uoflau

LoTaLLo GsrelbuL4
Slfla sTedr 05, Garoilsbui4 L6JmLAlmuë Gaijsp

S.ANIRUTH SAI RAM

Name/Guu
Sex/ureblsoTL :MALE

Date of Birth/ Lmis Gs :21/11/2010

SELVAN CLINIC
Place of Birth/pbs Lú VAKKIL STREET

KOVILPATTI
Name of Father/ pjb6»5uilsor Guuri :SANKARASUBBU

Name of Mother/ 5muilsar Guu : UMA MAHESWARI

Permanent Residential Address ofthe Parents :73/5.VINAYAGA NAGAR.

5T SE605UrtlG0r Bl6nvuT60T LG) (Lp5urt
KOVILPATTI

Address of parents at the tim of birth of the child : 73/5, VINAYAGA NAGAR,
GAIb65 Llpislsör (GLumgi GTÚ Sh6mguilr(psqufl
KOVILPATTI

Registration No. / ufloy 6T600T :179/2010/05

Registreof rtheGris
Date of Registsio
hs and
Gs$ 24/11/2010

Date o e / 04 Signatureof Issuing Authority

GT60r0l5y 6fliuaurfls0T 6msoluumULLD
Municay
REBISTRAR OF BIRTHS AND DEATHS.
ivision KOVILPATTI MUNICIPALITN
Address of the Issuing Authority
Office Seal 9 cgbply GT60TlBYy thiuoaufloör (Lpthsf
ENSURE REGISTRATION OF EVERY BIRTH AND DEATH