FORM NO.
5
GOVERNMENT OF ANDHRA PRADESH
MEDICAL & HEALTH DEPARTMENT
BIRTH CERTIFICATE
(Issued under section 12/17 of the Registration of Births and Deaths
Act, 1969 and Rule 8/13
Of the Andhra Pradesh Registration of Births and Deaths
Rules, 1999)
This is to certify that the following information has been taken from
the original record of birth, which is in the register for KARIMNAGAR (Local
Area/ local body) of Mandal MALLIAL of District KARIMNAGAR of State Andhra
Pradesh State.
Name: DONAKONDA VIJAY KUMAR
Sex: MALE
Date of Birth: 10/06/1987
Place of Birth: MALLIAL
Name of Mother: MALYALA GANGAMMA
Name of Father: DONAKONDA POCHAIAH
Address of the parents at the time of Birth of Child
Parents
Permanent Address of
H.No: 5-9-173
H.No: 3-143
KISHAN PURA
Village: MYADAMPALLY
SIKH WADA
Mandal: MALLIAL
HANAMKONDA
KARIMNAGAR
, WARANGAL
PIN: 506 001
District:
PIN: 505 452
Registration No.:
Date of Registration:
Authority
Signature of the Issuing