Civil Registration System https://crsgov.com/web/index.php/auth/birthCertificatePdf/B/bWF4V...

स.ं 1 �प�-5
उ�र �देश सरकार
No. 1 FORM-5
GOVERNMENT OF UTTAR PRADESH
िचिक�सा एवं �वा��य िवभाग
DEPARTMENT OF MEDICAL AND HEALTH
नगर पािलका प�रषद हापुड़
NAGAR PALIKA PARISHAD HAPUR

ज�म �माण-प�
BIRTH CERTIFICATE

(ज�म मृ�यु रिज��ीकरण अिधिनयम, 1969 क� धारा 12 / 17 तथा उ�र �देश ज�म मृ�यु रिज��ीकरण िनयम, 2002 के िनयम 8/13 के अतं ग�त जारी िकया गया )
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE UTTAR PRADESH REGISTRATION OF
BIRTHS & DEATHS RULES 2002.)

यह �मािणत िकया जाता है िन�निलिखत सूचना ज�म के मूल अिभलेख से ली गई है जो िक नगर पािलका प�रषद हापुड़ तहसील हापुड़ िजला हापुर रा�य/संघ �देश उ�र �देश,भारत के रिज�टर म� उि�लिखत है ।
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER FOR
NAGAR PALIKA PARISHAD HAPUR OF TAHSIL/BLOCK HAPUR OF DISTRICT HAPUR OF STATE/UNION TERRITORY UTTAR PRADESH, INDIA.

नाम / NAME : TASHI

िलंग / SEX : FEMALE
ज�म ितिथ | DATE OF BIRTH:
ज�म �थान / PLACE OF BIRTH :
19-08-2021
NINTEEN-AUGUST-TWENTY ONE HAPUR

माता का नाम / NAME OF MOTHER:

िपता का नाम / NAME OF FATHER :
RAJNI KUMARI
PUSHPENDRA KUMAR
आधार सं�या / MOTHER'S AADHAAR NO :
आधार सं�या / FATHER'S AADHAAR NO:
XXXXXXXX4246
XXXXXXXX9831
ब�चे के ज�म के समय माता-िपता का पता / ADDRESS OF PARENTS AT THE TIME OF BIRTH OF
माता-िपता के �थायी पता / PERMANENT ADDRESS OF PARENTS:
THE CHILD :
86 - SHASTRI NAGAR MEENAKSHI ROAD, HAPUR UP-245101
HAPUR

पजं ीकरण सं�या / REGISTRATION NUMBER:

पजं ीकरण तारीख / DATE OF REGISTRATION:
B-2022: 10-90347-005217
26-08-2021
िट�पणी / REMARKS (IF ANY):
----

जारी करने क� ितिथ / DATE OF ISSUE : जारी करने वाला �ािधकारी / ISSUING AUTHORITY :
21-04-22 11:24:48

UPDATED ON :
21-04-22 11:24:48

"THIS IS A COMPUTER GENERATED CERTIFICATE WHICH CONTAINS FACSIMILE SIGNATURE OF THE ISSUING AUTHORITY"
" THE GOVT. OF INDIA VIDE CIRCULAR NO. 1/12/2014-VS(CRS) DATED 27-JULY-2015 HAS
APPROVED THIS CERTIFICATE AS A VALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES".

"��येक ज�म एवं मृ�यु का पंजीकरण सुिनि�चत कर�" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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