Form No.
5
(See Rule 8)
Government of Tamil Nadu
Municipal Administration & Water Supply Department
TIRUNELVELI CORPORATION /
BIRTH CERTIFICATE -
(Issued Under Section 12/17 of the registration of Births and Deaths Act.1969 and Rule of 8 of Tamil Nadu Registration of Birth and Death Rules 2000)
This is to Certify that the following information has been taken from the original record of BIRTH which is
in the register for UNIT 13 of TIRUNELVELI CORPORATION of Taluk PALAYAMKOTTAI of District TIRUNELVELI of
State TAMIL NADU
Name / :
Sex / :
Date of Birth / : 25/Jul/2017
Place of Birth/ :
-627002
Name of Father / :
UID Number of Father / : XXXXXXXXXXXX
Name of Mother/ :
UID Number of Mother/ : XXXXXXXXXXXX
Permanent Residential Address of the Parents / :
Address of the Parents at the time of Birth of the Child / :
Registration Number / : 146/2017/13/01554
Date of Registration / : 03/Aug/2017
Remarks(If any) / :
Date of Issue / : 01/Apr/2026
Signature and Address of Issuing Authority
Registrar, Birth & Death:
Ensure Registration Of Every Birth And Death
Certificate No : BCP/146/2026/0005539
Note:This Certificate is computer generated and does not require any seal/signature the authenticity of this certificate can be verified
https:// [Link] .The Registration number is unique to each Birth.