मांक 42 महारा शासन फॉम-5

NO. 42 GOVERNMENT OF MAHARASHTRA FORM-5

आरोय वभाग
DEPARTMENT OF HEALTH

नगर नगम औरंगाबाद वाड डी

MUNICIPAL CORPORATION AURANGABAD WARD D

जम माणप
BIRTH CERTIFICATE

जम व मृयु नदणी अधनयम, 1969 या कलम 12/17 आिण महारा जम आिण मृयु नदणी नयम, 2000 चे नयम 8/13 अवये देयात आले आहे.
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE MAHARASHTRA REGISTRATION OF
BIRTHS & DEATHS RULES 2000)

मािणत करयात येत आहे क, खालल माहती जमाया मूळ अभलेखाया नदवहतून घेयात आल आहे , जी क नगर नगम औरंगाबाद वाड डी , तालुका
औरंगाबाद , िजहा औरंगाबाद , महारा राया, भारत या नदवहत उलेख आहे.
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER FOR
MUNICIPAL CORPORATION AURANGABAD WARD D OF TAHSIL/BLOCK AURANGABAD OF DISTRICT AURANGABAD OF STATE/UNION TERRITORY
MAHARASHTRA, INDIA.

नाव / NAME: ATHARVA DILIP CHANDURKAR लं ग / SEX: महला / MALE

जम तारख / DATE OF BIRTH: जम ठकाण/ PLACE OF BIRTH:

23-07-2022 E.S.I.S. HOSPITAL & NURSING HOME CHILKALTHANA
TWENTY THREE-JULY-TWO THOUSAND TWENTY TWO AURANGABAD

आईचे पूण नाव / NAME OF MOTHER: वडलांचे पूण नाव / NAME OF FATHER:
DIVYA DILIP CHANDURKAR DILIP KRUSHNA CHANDURKAR

आधार मां क / MOTHER'S AADHAAR NO: आधार मां क / FATHER'S AADHAAR NO:
XXXXXXXX8700 XXXXXXXX0305

बाळाया जमायावेळी आई-वडलांचा पा / ADDRESS OF PARENTS AT THE TIME OF आई-वडलांचा कायमचा पा/ PERMANENT ADDRESS OF
BIRTH OF THE CHILD: PARENTS:
16B, GONDHAVALI, WADI, ROON
ROON, RATNAGIRI, MAHARASHTRA, 416701. 16B, GONDHAVALI, WADI,
ROON, ROON, RATNAGIRI,
MAHARASHTRA, 416701.

नदणी मांक / REGISTRATION NUMBER: नदणी दनां क / DATE OF REGISTRATION:

456/28 23-07-2022

शेरा / REMARKS (IF ANY):

OLD CERTIFICATE NO.004057 DATE OF ISSUE. 24-03-2024 AS PER RECORD. SECOND
COPY.

माणप दयाचा दनांक / DATE OF ISSUE: नगमत करणारे ाधकार / ISSUING AUTHORITY :
24-03-2024
उप-रिजार (जम व मृयु)
SUB-REGISTRAR (BIRTH & DEATH)
नगर नगम औरंगाबाद वाड डी
MUNICIPAL CORPORATION AURANGABAD WARD D

UPDATED ON :
24-03-2024 14:24:01

"THIS IS A COMPUTER GENERATED CERTIFICATE WHICH CONTAINS FACSIMILE SIGNATURE OF THE ISSUING AUTHORITY"
" THE GOVT. OF INDIA VIDE CIRCULAR NO. 1/12/2014-VS(CRS) DATED 27-JULY-2015 HAS
APPROVED THIS CERTIFICATE AS A VALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES".

" येक जम आिण मृयूची घटना नदयाची खाी करा " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "