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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
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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

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