No.

00343

Form -5

ANDAMAN & NICOBAR

ADMINISTRATION
REGISTRAR OF BIRTHS & DEATHS

BIRTH CERTIFICATE

1999 h frH 8/13 3rfd

(lssued under Section 12/17 of the fh r )
the Andaman & Registration of Births and Deaths Act, 1969 and
Nicobar Island Registration Rules 8/13 of
of Births and Deaths
This is to certify that the Rules, 1999)
is the register for following information has been taken from the
(local area/local body)
District SOUTH ANDAMAN MUNICIPAL AREA, PORT BLAIR of Tehsil/Block original record of birth which
of Union Territory PORT BLAIR of
ANDAMAN AND NICOBAR ISLANDS.
AREA, PORT BLAIR TEÍTT PORT BLAIR fGI
SOUTH ANDAMAN s ANDAMAN AND
NICOBAR
TA/Name :R. PAVITRA
GH faf /Date of Birth : 16/02/2006
HIGI IH/Name of Mother
fi/ Sex : FEMALE
:VALLIAMMA
ftcT H/Name of Father :RAMESH

u RH/Place of birth:
G.B.PANT HOSPITAL,PORT BLAIR

Address of parents at the time of birth of child:

HADDO Permanent address of parents:
PORT BLAIR HADDO
PORT BLAIR
A&NISLANDS

ystory HN/Registration No. :334 12006 yofthu f&ia/Date of Registration:22/02/2006

feuuf/Remarks(if any) :TIME OF BIRTH:9:35 AM
G H faf /ate of issue :15/04/2011

kste issuing authority

urfea a YGT/Adress of the issuing authority
3.By0.No-1
er/Seal ipal Areà
n SeviCes

"Ensure registration of every birth and death / wràs aa qd gq itrUr f t s"

6iZPort Slair