मांक 1 महारा शासन फॉम-5
NO. 1 GOVERNMENT OF MAHARASHTRA FORM-5
आरोय वभाग
DEPARTMENT OF HEALTH
MUNICIPAL CORPORATION NASHIK EAST ZONE
जम माणप
BIRTH CERTIFICATE
जम व मृयु नदणी अधनयम, 1969 या कलम 12/17 आिण महारा जम आिण मृयु नदणी नयम, 2000 चे नयम 8/13 अवये देयात 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 करयात येत आहे क, खालल माहती जमाया मूळ अभलेखाया नदवहतून घेयात आल आहे , जी क , तालुका नाशक , िजहा नाशक
, महारा राया, भारत या नदवहत उलेख आहे.
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE
REGISTER FOR MUNICIPAL CORPORATION NASHIK EAST ZONE OF TAHSIL/BLOCK NASHIK OF DISTRICT NASHIK OF STATE/UNION
TERRITORY MAHARASHTRA, INDIA.
नाव / NAME: PRATIBHA NARENDRA PAWAR / तभा नर पवार लंग / SEX: महला / FEMALE
जम तारख / DATE OF BIRTH:
जम ठकाण/ PLACE OF BIRTH:
23-09-1966
NASHIK EAST /नाशक ईट
TWENTY-THIRD-SEPTEMBER-ONE THOUSAND NINE HUNDRED SIXTY SIX
आईचे पूण नाव / NAME OF MOTHER: वडलांचे पूण नाव / NAME OF FATHER:
KAMALABAI / कमळाबाई NARENDRA SAHADU PAWAR / नर सहादू पवार
आधार मांक / MOTHER'S AADHAAR NO: आधार मांक / FATHER'S AADHAAR NO:
बाळाया जमायावेळी आई-वडलांचा पा / ADDRESS OF PARENTS AT THE TIME आई-वडलांचा कायमचा पा/ PERMANENT ADDRESS OF
OF BIRTH OF THE CHILD: PARENTS:
-- / -- CHAWHATA 3450 / चहाटा ३४५०
नदणी मांक / REGISTRATION NUMBER: नदणी दनांक / DATE OF REGISTRATION:
3744 26-09-1966
शेरा / REMARKS (IF ANY):
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माणप दयाचा दनांक / DATE OF ISSUE: नगमत करणारे ाधकार / ISSUING AUTHORITY :
06-02-2023
उप-रिजार (जम व मृयु)
SUB-REGISTRAR (BIRTH & DEATH)
MUNICIPAL CORPORATION NASHIK EAST ZONE
UPDATED ON :
06-02-2023 14:51:03
"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 जम आिण मृयूची घटना नदयाची खाी करा " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "
