(CCBDR Form-3A)

People’s Republic of Bangladesh

Office of the Registrar of Birth and Death
Dhaka City Corporation
Dhaka Bangladesh

Birth Certificate
[Rule-9, of Birth and Death Registration (City Corporation) Rules, 2006]
(Extract from Birth Register)

Register No. : 14

Date of Registration : 26/04/09

(dd mm yy )
26/04/09
Registration No. 1 4 0 5 5 4
(dd mm yy )

Personal Identification No. 2 0 0 1 3 0 9 0 4 2 6 1 4 0 5 5 4

Name : Arfin Ahmed

Date of Birth (AD) (In digit) 19/03/2001

(dd mm yy ) Sex : Male Female

(In words) Nineteen March Two thousand one

Place of Birth : Dhaka

Present Address : 256, West Meradia Nobinbag, Dhaka Ps.- Khilgaon, Dhaka - 1219 .

Ward No: 26 Zone No. 04 City Corporation : Dhaka Country : Bangladesh

Father’s Name : Md. Somun Nationality :Bangladeshi

Mother’s Name : Kadija Nationality :Bangladeshi

Permanent Address : Vill.- Rutgaon, Po.- Baliapara, Ps.- Sonargaon, Dist.- Narayangonj

(Signature and Name of Refistrar with seal)

Seal of the Registar’s Office