ਰਲਜਸਟਰੇਸ਼ਨ ਨੰਬਰ/Registration No:BU/ES/23/0050715941 Document Sr.

No : Es17563884

ਪੰਜਾਬ ਸਰਕਾਰ/ Government of Punjab

ਸਸਹਤ ਤੇ ਪਸਰਵਾਰ ਭਲਾਈ ਸਵਭਾਗ / Health and Family Welfare Department

ਚੀਫ ਰਸਜਸਟਰਾਰ ਜਨਮ ਤੇ ਮੌਤ, ਪੰਜਾਬ / Chief Registrar (Birth & Death), Punjab
ਜਨਮ ਦਾ ਸਰਟੀਸਫਕੇਟ / Birth Certificate

ਡੀ ਪੀ ਐਚ /D.P.H - 368
ਫਾਰਮ / Form - 6

ਹਸਪਤਾਲ ਅਬੋਹਰ ਅਬੋਹਰ

This is to certify that following information has been taken from the original birth record which is registered in the birth register of
Sub Registrar , Births and Deaths,Block Civil Hospital Abohar,Tehsil Abohar District Fazilka of Punjab State for the year 2024.

ਨਾਮ /Name: ਹੇਮਲਤਾ / HEMLATA

ਿਲੰ ਗ /Sex: ਇਸਤਰੀ / Female

ਿਲਤਾ ਦਾ ਨਾਮ / Father's Name: ਚੰਦਰ ਪਾਲ / CHANDER PAL

ਦਾਦੇ ਦਾ ਨਾਂ / Grand Father's Name: ਬੁਲਾਕੇ ਰਾਮ / BULAKAI RAM

ਮਾਤਾ ਦਾ ਨਾਮ / Mother's Name: ਊਸ਼ਾ ਦੇਵੀ / USHA DEVI
ਜਨਮ ਲਮਤੀ / Date Of Birth: 04/08/1986 ਜਨਮ ਅਸਥਾਨ /Place of Birth: ABOHAR
ਰਲਜਸਟਰੇਸ਼ਨ ਦੀ ਮਤੀ /Date of Registration:30/03/2024 ਿਸਵਲ ਿਹਪਤਾਲ ਅਬੋਹਰ / CIVIL HOSPITAL ABOHAR

ਮਾਤਾ ਸਪਤਾ ਦਾ ਪ^ਕਾ ਪਤਾ

Address of Parents at the time of birth of the child Permanent Address of Parents
Street no 6 Indra Nagari Abohar , Street no 6 Indra Nagari Abohar
Fazilka Punjab 152116 Fazilka Punjab 152116

Date of Issuance : 30/03/2024 Signature of the Issuing Authority:

Signed By: GAGANDEEP SINGH
BOPARAI
Sign Date: 30/03/2024 2:46PM

Designation : Sub Registrar

Location : Civil Hospital Abohar

Remark - APPLICATION APPROVED

ਟੰ

Note:- Issued u/s 17 of the Registration of Births and Deaths Act, 1969 and rules 13 the Punjab Registration of Births and Deaths Rules 2004.

1. The authenticity of this document can be verified using document serial number at the web link 'https://esewa.punjab.gov.in/certificateVerification'
or by scanning QR code. Any discrepancy in details on this document as compared to those available on the verification web link renders this
document invalid.
2. This is a digitally signed certificate and doesn't require physical signature, or hologram, or stamp as per Punjab Government Notification no.
E122499/GRMC/172 Dated: 31-08-2022, available at 'https://punjab.gov.in'
3. The responsibility of verification of this document before accepting the same for any legal purposes would rest with the Institution / Organization /
Company or any other Entity where this document is produced.
4. This certificate is valid as per Information Technology Act 2000 as amended from time to time.
5. In case of any discrepancy, please inform the issuing authority about the discrepancy in the certificate.
.
********** Print Date 30/03/2024