c Civil Registration System

Birth Reporting X

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To

Death Reporting X

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To

 
 
 
 
 
         
       
 
सं. 1
No. 1
 
  प्रपत्र-5
Form-5
 
 
 
   
 
 
 
   
       
   
BIRTH CERTIFICATE
   
         
         
 
 
         
         
 
 
         
         
 
/ Name: BHARGAVA LAKKA / Sex: MALE
/ Date of Birth:
04-02-2021
FOUR FEBURUEY TWO THOUSAND TWENTY ONE
/ Place of birth:
VILLAGE GJM LAKE GARDENS POST RAMAGONDANAHALLI BOREWELL RD WHITEFIRLD PHASE 2 BANGALURU KARNATKA 560066
/ Name of Mother:
MADHHU LAKKA
/ Name of father:
.VENKATRAMANA LAKKA
/ MOTHER'S AADHAR:
 
/ FATHER'S AADHAR
 
/ Address of parents at the time of birth of the child:
VILLAGE GJM LAKE GARDENS POST RAMAGONDANAHALLI BOREWELL RD WHITEFIRLD PHASE 2 BANGALURU KARNATKA 560066
/ Permanent address of parents:
VILLAGE GJM LAKE GARDENS POST RAMAGONDANAHALLI BOREWELL RD WHITEFIRLD PHASE 2 BANGALURU KARNATKA 560066
/ Registration Number:
B-2024: 09-90347-004180
 / Date of Registration:
05-08-2022
/ Remarks (if any):
---

/ Date of issue:
19-02-24 01:54:43
/ Issuing Authority :



Updated on :
19-02-24 01:54:43
 
   
 
"This is a computer generated certificate which contains facsimile signature of the Issuing Authority"
" The Govt. of India vide circular No. 1/12/2014-VS(CRS) dated 27-July-2015 has
approved this certificate as a valid legal document for all official purposes".
" " / "Ensure registration of every birth and death"
 
         
       
         
 
 
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