FV7MPTI
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) West Champaran Municipal Corporation
of Tahsil/Block West Champaran Sadar of District West Champaran of State Bihar.
Name: ADITYA KUMAR
Gender: male
Date of Birth: 22-DECEMBER-2018
Place of Birth: CHANPATIA, WEST CHAMPARAN, BIHAR
Name of Father: UMESH SAH
Name of Mother: SONI DEVI
Permanent Address : WARD NO-11, CHANPATIA, WEST CHAMPARAN, BIHAR- 845449
Address of Parents at the time of Birth of Child : WARD NO-11, CHANPATIA, WEST CHAMPARAN, BIHAR- 845449
Registration Number: 30647/7/9409/2026
Date of Registration: 30-DECEMBER-2018
Date of Issue: 03-JANUARY-2019
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"