SI.NO.

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102715
GOVERNMENT OF KARNATAKA
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Chief Registrar of Birth and Death
do.5 (8de duteo)
Form No. 5(See Rule 8)
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( 12/17 de
e 7 -08 BIRTH CERTIFICATE 3.>1.?.
(Issued Under Section E/ 17)
de Road,

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This is to certify that the followinginformation has been taken from the original record of
birth "hich is in the register or Bruhat Bangalore Mahanagara Palikc, Bangalore District of Karnataka
State.

i) ! Nanie.

2)30601) / NameofFatherm' SURE NDP a

3) / Nameof Mother.... YNDU

4) eot$ / Sex........... 5) æööÜöd æOea.D/Date of Bit-th.

6) dae058 3@Oeæ-) 7) dne058 60936

Date of registration... Reg No.-m.

8) asg
no; Acme , 13ccn8Q)cüe
Place of Birth..

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Date :