F25MPGY
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) Supaul Municipal Corporation
of Tahsil/Block Supaul Sadar of District Supaul of State Bihar.
Name: RAJ MOHAN YADAV
Gender: male
Date of Birth: 13-NOVEMBER-2020
Place of Birth: PRATAPGANJ
Name of Father: RAJENDRA PRASAD YADAV
Name of Mother: MAMTA YADAV
Permanent Address : AT BHAWANIPUR, WARD NO- 03 PRATAPGANJ, BHAWANIPUR, SUPAUL, BIHAR, 852125
Address of Parents at the time of Birth of Child : AT BHAWANIPUR, WARD NO- 03 PRATAPGANJ, BHAWANIPUR, SUPAUL, BIHAR, 852125
Registration Number: 68499/2/8200/2026
Date of Registration: 11-MAY-2026
Date of Issue: 15-MAY-2026
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"