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JXÊ6O Government of Tamil Nadu Municipal Administration & Water Supply Department BIRTH CERTIFICATE - LP~©vÊDX}PYI
(Issued Under Section 12/17 of the registration of Births and Deaths Act.1969 and Rule of 8 of Tamil Nadu Registration of Birth and Death Rules 2000) This is to Certify that the following information has been taken from the original record of BIRTH which is in the register for DIVISION III of TIRUVANNAMALAI CITY MUNICIPAL CORPORATION of Taluk TIRUVANNAMALAI of District TIRUVANNAMALAI of State TAMIL NADU Name / ]LNƫ : Sex / LXQYK : Date of Birth / LP|IÊ^IIY : Place of Birth / LP|IÊ8G : GOVERNMENT HOSPITAL TIRUVANNAMALAI,. 606601 Name of Father / I|_IN}Ê]LNƫ : UID Number of Father / I|_IN}Ê 7IXƫ Ê<z : XXXXXXXXXXXX Name of Mother / IXN}Ê]LNƫ : MANONMANI UID Number of Mother/ IXN}Ê 7IXƫ Ê<z : XXXXXXXXXXXX Permanent Residential Address of the Parents / IXÊI|_INƬ}ÊJY_QNXKÊT yÊ«BTƬ : ... Address of the Parents at the time of Birth of the Child / S|_IÊLP~L}Ê^LX¢ÊIXÊI|_INƬ}Ê «BTƬ : ... Registration Number / LIYºÊ<z : Date of Registration / LIYºÊ]DIÊ^IIY : Remarks(If any) / : Date of Issue / ^IIY : Signature and Address of Issuing Authority DX}PYI
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JX ÊMXJYQÊÊ IY ̄TzHXM_Q ÊÊÊMXTyGÊ IY ̄TzHXM_Q ÊTyGÊ IY ̄TzHXM_QÊMXJBOXyDY ÊLƬºÊ<zÊ Ê>Ê^Dƫ|IÊ6DÊLP~©ÊLIY^TyQY ̄|¢Ê<tB~LyG_TÊ<KÊ DX}PYI
ÊTSuB~LBY}P¢Ø ÊÊÊÊLTÊß ÊTIYÊâ>~ÊLXƫtB Form No. 5 (See Rule 8) Registrar, Birth & Death: TIRUVANNAMALAI CITY MUNICIPAL CORPORATION Ensure Registration Of Every Birth And Death LP~©ÊÙÊ8P~©~ÊLIYT_KÊ:²IYÊ]DT ƫ FEMALE 14/Dec/2006 NALLAVANPALAYAM,TIRUVANNAMALAI, NALLAVANPALAYAM,TIRUVANNAMALAI, 543/2006/03/06523 15/Dec/2006 25/Feb/200 7 RAJA PANDI BAVANI ................ ?............. ??????..