F2Q3PVR
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) Muzaffarpur Municipal Corporation
of Tahsil/Block Muzaffarpur Sadar of District Muzaffarpur of State Bihar.
Name: ALISA KHATUN
Gender: female
Date of Birth: 22-DECEMBER-2016
Place of Birth: SABDARGAN SITAMARI
Name of Father: MOHD IRSHAD
Name of Mother: TAVSSUM KHATUN
Permanent Address : GHOSAUT MUZZAFARPUR BIHAR-843128
Address of Parents at the time of Birth of Child : GHOSAUT MUZZAFARPUR BIHAR-843128
Registration Number: 55079/6/2727/2026
Date of Registration: 03-FEBRUARY-2022
Date of Issue: 03-FEBRUARY-2022
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"