.
3HRTS TTATT 47-5
NO. 1 GOVERNMENT OF UTTARAKHAND FORM-5
TrHT FATRT TT vXAT TTOT fHTT DEPARTMENT OF MEDICAL HEALTH AND FAMILY
WELFARE
JRNOT T
NAGAR NIGAM ROORKEE
ATU-
BIRTH CENTIFICATE
ISSUED UNDER SECTION12/17OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE B/13 OF THE UTTARAKHAND REGISTRATION
OF BIRTHS & DEATHS RULES 2003)
THIS IS TO CERTIFY THAT THE FOLLowING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER
FOR NAGAR NIGAM ROORKEE OF TAHSIL/BLOCK ROORKEE OF DISTRICT HARIDWAR OF STATE/UNION TERRITORY UTTARAKHAND, INDIA.
TH /NAME:
fT/SEX:YT/MALE
iFH A I DATE OF BIRTH: H TYI PLACE OF BIRTH:
25-11-2007 377. I T TH .
TWENTY-FIFTH-NOVEMBER-TWO THOUSAND SEVEN 5 , F T , TRGR,
HTAT NAMiL0F MOTHER: YT HT NAME OF FATHER:
3HTTYT MOTHER'S AADHAA" NO: TaT FATHER'S AADHAAR NO:
t HHAT ATAT-9AT AT TAT/ADDRESS OFPARENTS AT THE TIME OF ATAT-TUAT TYTOT TaTy PERMANENT ADDRESS OF
BIRTH OF THE CHILD: PARENTS:
377, TTd YTA 377, TT- TA,
3HT5t, FTETT, E S T , FT*GTT,
TiraTU EUT /REGISTRATION NUMBER: u-tarr aRE / DATE OF REGISTRATION:
B-2017:5-90069-006456 01-10-2017
feuyot /REMARKS (IF ANY):
TT fr/DATE OF ISSUE: Tr TaT A t 7 IsSUING AUTHORITY
17-10-2017
TRAR REGISTRAR (BIRTH &DEATH)
DEPA . NAGAR NIGAMROORKEE
RTM BIRTH P5ATH REGISTRA
UPDATED ON : NAGANAA, ROORKEE
01-10-2017 15:17:08 LSPT. HARIDVWAR UTTARAKHAN
h
(INDiA
NAGAR NI¬AM
KE
UTTA
"THIS IS A cOMPUTER GENERATED CERTIFICATE.
1/12/2014-VS(CRS) DATED 27-JULY-2015 HAS
"THE GOVT. OF INDIA VIDE CIRCULAR NO.
DOCUMENT FOR ALL OFFICIAL PURPOSES".
APPROVED THIS CERTIFICATE AS A VALID LEGAL
FT TH T Z yArRT / ENSURE REGISTRATION OE EVERY BIRTIH AND DEATU"
yHTT HAT: UK13CACO204/200141984
71 fa: 30 w0 TATZA sfafAzu 2000 4 a 3raTTTz ATJ ZAT)
fT sT7T TAT UK13CAC0204/20014198
Tr fat :24-August-2020
4TAT H
T59TT
402/1 HTFgu, Tst, zRar
E T 300 T T (TTT fAAT, TT9TfATi TT 3 fe fy aTTeTT fefaq7 1994 ) T f
3ferttz 1994 7TT -T (THAI FAT 22/16, 92-T-1995 totfto faaTT 08 feH 1995 zTT TT
T/ ET
afTT HTHTT: TET
TE THT7 TZATAT/AEYT (HTK TaFTT) STETT THTT 23-Aug-2020 TETT TT fA fT TATI
Digitally signed by
SUNNENA RANA
Date 2020.08.23
7 TT: cscroo1 151320 +05:30
FftaTT
H a f4T T T
XATT a F I T TYT T http://edistrict. uk.gov.in
3TETR
HTNT HRGhIR
Government of India
Unique Identification Authority of India
TAT AiST/ Enrollment No.: 2729/00060/93377
To
&Atharv Kumar
S/O Pawan Kumar, 402/1 Solanipuram,
VTC: Roorkee,
PO: Roorkee,
Sub District: Roorkee, District: Haridwar,
State: Uttarakhand,
PIN Code: 247667,
Mobile: 9536201806
MF074264818FI
HTYT HTUTR HTT/ Your Aadhaar No.
7015 7362 0718
AT 3HTR, AI TFIA
AIRA HR
Government of India 3HTYTR
Atharv Kumar
THAR DOB 25/11/2007
gET/ Male
7015 7362 0718
AT 3HTTN, HNT TETIT
