FOGEXN7
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) Darbhanga Municipal Corporation
of Tahsil/Block Darbhanga Sadar of District Darbhanga of State Bihar.
Name: PRINCE KUMAR DAS
Gender: male
Date of Birth: 20-DECEMBER-2020
Place of Birth: BAGHLA KAMALPUR PS BISHANPUR,PANCHOBH DIL LAHI HANUMANNAGAR DARBHANGA BIHAR 846003
Name of Father: PRAKASH DAS
Name of Mother: PRIYANKA KUMARI
Permanent Address : BAGHLA KAMALPUR PS BISHANPUR,PANCHOBH DIL LAHI HANUMANNAGAR DARBHANGA BIHAR 846003
Address of Parents at the time of Birth of Child : BAGHLA KAMALPUR PS BISHANPUR,PANCHOBH DIL LAHI HANUMANNAGAR DARBHANGA BIHAR 846003
Registration Number: 52086/4/6451/2026
Date of Registration: 04-APRIL-2021
Date of Issue: 04-APRIL-2021
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"