.

8Tj̆\hRjSD^ah\h58apJpD°WjIpWj\hˆeSjKƛ\WhȺl`^°DP½\h5Tj_pah\h58ajJpȐ[h^SWhȤkK^hS^hԌ]Wh7\^°_j‰Kƣ_hWh
Ȣk5DhahaaˆP]hShɀkDhWhȹkE_jdhT`Ž˴h\be°^Wh^‰KƨN^\h5Jp

This is to certify that the following information has been taken from the original record of birth which is in the register for Village/City
Bhukhli-Santhali of Taluka Kunkavav Vadia of District Amreli of Gujarat State, India.

Wh\Name : ‫ٶڤڗژڏڰڂ‬Gautambhai ĤiSSex : ‫ڧڔ‬Ἐ‫ڟ‬Male

Kƛ\Sh^ŽEDate of Birth : 15/04/2004 Kƛ\ƨT`Place of Birth :

Thursday, April 15, 2004 Bhukhli Santhli

\hShȵk5Wh\Name of Mother : iXShȵk5Wh\Name of Father :

‫ړڬږڤڑښڤڞ‬Sharadaben VWĥ[h:ĤUaDhanjibhai Jadav

Zh`DWhKƛ\d\]p\hShiXShȵk5d^WhȺk5Address of parents \hShiXShȵk5Dh]\jd^WhȺk5Permanent Address of

at the time of Birth of child : Parents :
Bhukhli Santhli / ȹkE_jdh5T`Ž Bhukhli Santhli ȹkE_jdh5T`Ž

WҭVRj˲\h5DRegistration No. : 6 WҭVRjWjSh^ŽERegistration Date : 28/04/2004

^Ž\hD½d iabpcWҭV Remarks (if any) : ̆\hRX́W5Z^Certificate No. : B200410012343

/
̆\hRX́DhQŽ8Ɯ]hWjSh^ŽEDate of issue : ̆\hRX́8XWh^dĂhiVDh^ŽWjdeŽSignature of Issuing
Authority :
11/01/2024 ..................................................................................

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