7
ser dem 5 \
FORM NO.S
Goverment of Rajasthan #
safes wa wifeadt Peter
Directorate of Economics & Statistics
Registrar - GOVERNMENT HOSPITAL KUCHAMANCITY, NAGAUR,
er TOT
BIRTH CERTIFICATE
(ae ah my efter ia 1989 one 12/17 she x Gem TRS
tae Pr, 2000 3 a et, .
(issued under Section 12/17 of the Registration of Births and Deaths Act,1969 and Rule 8/13 of the Rajasthan
Registration of Births and Deaths Rules, 2000)
‘ag sora Fear ora & Pe RAT Maar Set a ae SR TA Te Bt (eee eee Pera) Tort
Riera eae sete wok Brat aU ASTI ToT TEU, A aT ARE 8 |
“This & to ootiy tht the folowing information hes been tsken fom the ciginel record of bith whichis the registr for (Local aren / Local
body) GOVERNWENT HOSPITAL KUCHAMANCITY of Tent / Block xxx of Disiet NAGAUR of Site | Union Terry Rajestnan, Indi
IeUName: ser gare / KAYA KUMAWAT feriSex fFan/FEMALE
‘see (BRVDate of Bith: 08/04/2022 Siem EETYPlace of Birth:
anther RATE aeTs RYE
Dap a seem at ioc eens SUT AHANAT GOVERNMENT HOSPITAL KUCHAMAN CITY
‘Fray aU swuMother Aachar No: +8369
‘rar a 7IEUName of Father: Arey ewer om / SHIMIBHU DAYAL KUMAWAT
‘Rr a1 oene siewather Aadhar No: 2486
ad oee & ana aren Ran eT at Pa at Eh a:
Address. of porents at the time of birth of the chit Permanent Addrass of the parents
99 a ear Cast / age / paw / ate / 80 = efter chen / saga / gam / ate |
aareur / 59 KH KERIYA TORDA / ROOPPURA ‘cagara / 59 KH KERIYA TORDA /
/ KUCHAMAN / NAGAUR / RAJASTHAN ROOPPURA / KUCHAMAN / NAGAUR /
RAJASTHAN