FFTE98V
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) Gaya Municipal Corporation
of Tahsil/Block Gaya Sadar of District Gaya of State Bihar.
Name: GOUTAM KUMAR
Gender: male
Date of Birth: 01-JUNE-2002
Place of Birth: FATEHPUR
Name of Father: BADHAN SAW
Name of Mother: GITA DEVI
Permanent Address : GURIYAWAN POST ITWAN THANA MOHANPUR GAYA 824231
Address of Parents at the time of Birth of Child : GURIYAWAN POST ITWAN THANA MOHANPUR GAYA 824231
Registration Number: 57420/9/9386/2026
Date of Registration: 03-FEBRUARY-2026
Date of Issue: 03-FEBRUARY-2026
Signature of Issuing Authority
"Ensure Registration of Every Birth and Death"