मांक 1 महारा शासन फॉम-5

NO. 1 GOVERNMENT OF MAHARASHTRA FORM-5

आरोय वभाग
DEPARTMENT OF HEALTH
नगर परषद िजंतूर
MUNICIPAL COUNCIL JINTUR

जम माणप
BIRTH CERTIFICATE

जम व मृयु नदणी अधनयम, 1969 या कलम 12/17 आिण महारा जम आिण मृयु नदणी नयम, 2000 चे नयम 8/13 अवये देयात आले आहे.
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE MAHARASHTRA REGISTRATION OF
BIRTHS & DEATHS RULES 2000)

मािणत करयात येत आहे क, खालल माहती जमाया मूळ अभलेखाया नदवहतून घेयात आल आहे , जी क नगर परषद िजंतूर , तालुका िजंतूर , िजहा
परभणी , महारा राया, भारत या नदवहत उलेख आहे.
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER FOR
MUNICIPAL COUNCIL JINTUR OF TAHSIL/BLOCK JINTUR OF DISTRICT PARBHANI OF STATE/UNION TERRITORY MAHARASHTRA, INDIA.

नाव / NAME: SHRAWANI LIMBAJI AMBHORE / ावणी लंबाजी अंभोरे लंग / SEX: महला / FEMALE

जम तारख / DATE OF BIRTH:

जम ठकाण/ PLACE OF BIRTH:
02-08-2016
RURAL HOSPITAL JINTUR/ामीण रणालय िजंतूर
SECOND-AUGUST-TWO THOUSAND SIXTEEN

आईचे पूण नाव / NAME OF MOTHER: वडलांचे पूण नाव / NAME OF FATHER:
SHARADA LIMBAJI AMBHORE / शारदा लंबाजी अंभोरे LIMBAJI PANDITRAO AMBHORE / लंबाजी पंडतराव अंभोरे

आधार मांक / MOTHER'S AADHAAR NO: आधार मांक / FATHER'S AADHAAR NO:

बाळाया जमायावेळी आई-वडलांचा पा / ADDRESS OF PARENTS AT THE TIME OF आई-वडलांचा कायमचा पा/ PERMANENT ADDRESS OF PARENTS:
BIRTH OF THE CHILD:

SHELGAON , SHELGAON JAHANGIR, CHIKHLI, BULDANA, SHELGAON, SHELGAON JAHANGIR, CHIKHLI, BULDANA,
MAHARASHTRA MAHARASHTRA

शेलगाव , शेलगावजहांगीर, चखल, बुलडाणा, शेलगाव, शेलगावजहांगीर, चखल, बुलडाणा,

महारा महारा

नदणी मांक / REGISTRATION NUMBER: नदणी ​दनांक / DATE OF REGISTRATION:

B-2016: 27-90113-001376 30-08-2016

शेरा / REMARKS (IF ANY):

TOB 7.40AM

माणप दयाचा दनांक / DATE OF ISSUE: नगमत करणारे ाधकार / ISSUING AUTHORITY :
14-02-2022
रिजार (जम व मृयु)
REGISTRAR (BIRTH & DEATH)
नगर परषद िजंतूर
MUNICIPAL COUNCIL JINTUR

UPDATED ON :
14-02-2022 13:38:15

"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".

" येक जम आिण मृयूची घटना नदयाची खाी करा " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "