Certificate No.

1BF/16H / IAQ/31511 Form - 5

• GOVERNMENT OF MAHARASHTRA
e •
HEALTH DEPARTMENT

Karad Municipal Council Karad

(Issued under section 12/17 of the Registration of Births & Deaths Act, 1969 and Rule 8/13 of the Maharashtra
Registration of Births and Deaths RuIes,2000.)

This is to certify that the following information has been taken from the original record of birth which is the register
for Karad Municipal Council Karad, Karad of Tahsil / Karad of District Satara of Maharashtra State.

अक्षता

Name of child: AKSHATA Sex : FEMALE

: २८-११-२००४

Date of Birth: 28-11-2004 Place of Birth: Kottage Hospital – Karad

आई चे पूर्ण नाव :- सारिका संजय चौगुले
Name of Mother :- SARIKA SANJAY CHOUGULE
बाळाच्या जन्माचे वेळी आई वडिलांचापत्ता :-
मु.पो.कार्वे नाका ता.कराड जि.सातारा
जि.सातारा
Address of parents at the time of birth of the child:
A.P. KARVENAKA TAL. KARAD DIS. SATARA
वडीलांचे पूर्ण नाव :- संजय शेलार चौगुले
Name of Father :- SANJAY SHELAR CHOUGULE
आई वडिलांचा कायमचा पत्ता:
मु.पो. कार्वे नाका ता. कराड
Permanent Address of Parents:
A.P. KARVENAKA TAL. KARAD DIS. SATARA

नोंदणी क्रमांक :- ३६१८ नोंदणी दिनांक :- २८-१२-

२००४
Registration No :- 3618 Date of Registration :- 28-11-2004
शेरा/Remarks (if any) :-

प्रमाणपत्र दिल्यास दिनांक:-२५-०७-२०२१ ११:५६:५४

Date of issue of certificate: 25 07-2021 11:56:54

Signature of the issuing authority

Registrar of Birth & Death / Chief Officer,

Karad Municipal Council, Karad
"Ensure Registration of évery birth & death"