FCX9SQE
FORM NUMBER - 5
[SEE RULE - 8]
[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)
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) Sitamarhi Municipal Corporation
of Tahsil/Block Sitamarhi Sadar of District Sitamarhi of State Bihar.
of Birth which is the register for (Local Body) Sitamarhi Municipal Corporation
of Tahsil/Block Sitamarhi Sadar of District Sitamarhi of State Bihar.
| Name | : SAMIKSHA KUMARI |
| Gender | : female |
| Date of Birth | : 18-FEBRUARY-2015 |
| Place of Birth | : SAFDURJUNG HOSPITAL, SITAMARHI |
| Name of Father | : BALBODH JHA |
| Name of Mother | : USHA DEVI |
| Permanent Address | : WARD NO-10, MADHEERA, SONBARSA, SITAMARHI, BIHAR-843317 |
| Address of Parents at the time of Birth of Child | : WARD NO-10, MADHEERA, SONBARSA, SITAMARHI, BIHAR-843317 |
| Registration Number | : 93112/4/5654/2026 |
| Date of Registration | : 25-FEBRUARY-2016 |
| Date of Issue | : 27-FEBRUARY-2016 |
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"
