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Birth Certificate from Khargram Hospital

This document is a birth certificate issued by the Government of West Bengal for Madhuri Das, born on December 14, 1997, at Primary Health Centre Margram. It includes details such as the names of her parents, their identity proofs, and addresses. The certificate is registered under the Registration of Births & Deaths Act, 1969, and is valid for official purposes.

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93 views1 page

Birth Certificate from Khargram Hospital

This document is a birth certificate issued by the Government of West Bengal for Madhuri Das, born on December 14, 1997, at Primary Health Centre Margram. It includes details such as the names of her parents, their identity proofs, and addresses. The certificate is registered under the Registration of Births & Deaths Act, 1969, and is valid for official purposes.

Uploaded by

bnupur496
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Form-5

GOVERNMENT OF WEST BENGAL


DEPARTMENT OF HEALTH AND FAMILY WELFARE

RURAL HOSPITAL KHARGRAM

BIRTH CERTIFICATE

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE WEST BENGAL
REGISTRATION OF BIRTHS & DEATHS RULES 2000.)

THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS
THE REGISTER FOR RURAL HOSPITAL KHARGRAM OF BLOCK/MUNICIPALITY KHARGRAM OF DISTRICT MURSHIDABAD OF
STATE WEST BENGAL, INDIA.

NAME : MADHURI DAS GENDER : FEMALE

DATE OF BIRTH : 14/12/1997 PLACE OF BIRTH : PRIMARY HEALTH CENTRE MARGRAM,


KHARGRAM, MURSHIDABAD,
KHARGRAM, WEST BENGAL

NAME OF MOTHER : SUNITA DAS NAME OF FATHER : KRISHNA DAS

MOTHER'S IDENTITY PROOF : AADHAAR- FATHER'S IDENTITY PROOF : AADHAAR- XXXXXXXX7463


XXXXXXXX5292

PRESENT ADDRESS OF MOTHER VILLAGE/TOWN:- MARGRAM,KHARGRAM BLOCK,DIST:- MURSHIDABAD,WEST BENGAL-742147


AT THE TIME BIRTH OF THE
CHILD :

PERMANENT ADDRESS OF STREET/LANE:- WORD NO 1,LOCALITY/POST OFFICE:- BENGAL ENAMEL,VILLAGE/TOWN:-


MOTHER : MARGRAM,KHARGRAM BLOCK,DIST:- MURSHIDABAD,WEST BENGAL-743122

CERTIFICATE NO : B/2025/1928255 DATE OF REGISTRATION : 19/11/2025

S-UHID : 91030839251604 REMARKS (IF ANY) :

DATE OF ISSUE : 19/11/2025 UDIN : ----

UPDATED ON : 2025-11-12 [Link] ISSUING AUTHORITY :

Signature Not Verified


Digitally Signed.
Name: Gazi Rintu
Date: 19-Nov-2025 [Link]

REGISTRAR (BIRTH & DEATH)


RURAL HOSPITAL KHARGRAM

"THIS IS A COMPUTER GENERATED CERTIFICATE."


THE [Link] 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

"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH"

The QR Code and Certificate Number can be verified through the portal [Link]

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