FU96AGD
FORM NUMBER - 5
[SEE RULE - 8]

GOVERNMENT OF BIHAR

DEPARTMENT OF PLANNING AND DEVELOPMENT

DIRECTORATE OF ECONOMICS AND STATISTICS

BIRTH CERTIFICATE
(Issued under Section 12 of Registration of Births & Deaths Act, 1969 and Rule 8/13
of the Bihar 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 the register for (Local Body) Aurangabad Municipal Corporation
of Tahsil/Block Aurangabad Sadar of District Aurangabad of State Bihar.
Name: PAYAL BALAJI YAMGAR
Gender: female
Date of Birth: 13-AUGUST-2010
Place of Birth: SADAR HOSPITAL AURANGABAD , BIHAR
Name of Father: BALAJI GANPAT YAMGAR
Name of Mother: ANITA BALAJI YAMGAR
Permanent Address : SHAM NAGAR, 12 N PATI , HARANGUL BK , LATUR , MAHARASHTRA 413531
Address of Parents at the time of Birth of Child : SHAM NAGAR, 12 N PATI , HARANGUL BK , LATUR , MAHARASHTRA 413531
Registration Number: 91051/5/6796/2026
Date of Registration: 18-AUGUST-2010
Date of Issue: 18-AUGUST-2010
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"