FREUF0N
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) Buxar Municipal Corporation
of Tahsil/Block Buxar Sadar of District Buxar of State Bihar.
Name: KHUSHI THAKUR
Gender: female
Date of Birth: 02-MARCH-2010
Place of Birth: BASAHI , JALHARA , BUXAR, BIHAR ,802128
Name of Father: CHANDAN THAKUR
Name of Mother: RINA DEVI
Permanent Address : BASAHI, JALHARA, BUXAR, BIHAR,802128
Address of Parents at the time of Birth of Child : BASAHI , JALHARA, BUXAR, BIHAR,802128
Registration Number: 71093/6/1030/2026
Date of Registration: 15-APRIL-2026
Date of Issue: 15-APRIL-2026
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"