FVNPYWC
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) Banka Municipal Corporation
of Tahsil/Block Banka Sadar of District Banka of State Bihar.
Name: Md Arif
Gender: male
Date of Birth: 01-JANUARY-2004
Place of Birth: Dhoriya
Name of Father: Md Irfan
Name of Mother: BiBi Sachchi khatoon
Permanent Address : Hasai PS DHORIYA DIST Banka Bihar PIN 813205
Address of Parents at the time of Birth of Child : Hasai PS DHORIYA DIST Banka Bihar PIN 813205
Registration Number: 16680/5/7222/2026
Date of Registration: 12-MAY-2026
Date of Issue: 04-MAY-2026
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"