సంఖ 1 ఆంధ పే పభుతము ారం-5

NO. 1 GOVERNMENT OF ANDHRA PRADESH FORM-5

ైద,ఆోగ మియు టుంబ సంేమ ాఖ
DEPARTMENT OF HEALTH, MEDICAL AND FAMILY WELFARE

MUNCIPALITY NARSIPATNAM

జనన ధృవ పతము

BIRTH CERTIFICATE

(జనన మరణ నదు చటం 1969, 12/17 గము పారము, ఆంధ పే జనన మరణ నదు బంధనలు 1999, 8/13 ింద ాీేయడైని)
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE ANDHRA PRADESH
REGISTRATION OF BIRTHS & DEATHS RULES 1999)

రత ేశము, ఆంధపే ాషము అనాపలి లా నీపటం మండలము ముాటీ నీపటం (ాక పేశము) జనన మరణ ిషేరులో జనాి
సంబంింన అసలు ిారు నుంి, ింి సమారము సుొనబినద ధృకించడైని.
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER
FOR MUNCIPALITY NARSIPATNAM OF TAHSIL/BLOCK NARSIPATNAM OF DISTRICT ANAKAPALLI OF STATE/UNION TERRITORY ANDHRA PRADESH,
INDIA.

రు / NAME: KANDA TANANYA ంగము / SEX: సీ FEMALE

పటిన ేీ / DATE OF BIRTH:

పటిన సలము/ PLACE OF BIRTH:
11-06-2022
SATYA SAI HOSPITAL
ELEVENTH-JUNE-TWO THOUSAND TWENTY TWO

తలి రు / NAME OF MOTHER: తంి రు / NAME OF FATHER:

KOTA SUPRAJA KANDA HARI PRASAD

ఆా సంఖ / MOTHER'S AADHAAR NO: ఆా సంఖ / FATHER'S AADHAAR NO:
XXXXXXXX7524
XXXXXXXX1706

డ జంనపడు తలిదండులు రుామ / ADDRESS OF PARENTS AT THE TIME తలిదండులు క ిరాసప రుామ/ PERMANENT ADDRESS
OF BIRTH OF THE CHILD: OF PARENTS:
25-60, KAPU STREET,
NARSIPATNAM, , NARSIPATNAM, ANAKAPALLI, ANDHRA PRADESH- 531116 25-60, KAPU STREET,
NARSIPATNAM, NARSIPATNAM, ANAKAPALLI,
ANDHRA PRADESH- 531116

నదు సంఖ / REGISTRATION NUMBER: నదు ేీ / DATE OF REGISTRATION:

B-2022: 28-16477-000740 02-07-2022

ేాంశములు / REMARKS (IF ANY):

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ాీ ేిన ేి / DATE OF ISSUE: ాి ేిన అిాి సంతకం / ISSUING AUTHORITY :
01-03-2023
(జనన మరణ ిషా)
REGISTRAR (BIRTH & DEATH)

MUNCIPALITY NARSIPATNAM

UPDATED ON :
01-03-2023 12:17:31

"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".

" ప జననము, ప మరణము తపంా 21 ోలలో నదు ేయంి" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "