doy1 FORM-5
NO. 1 GOVERNMENT OF ANDHRA PRADESH
DEPARTMENT OF HEALTH. MEDICAL AND FAMILY WELFARE
S
MUNICIPALITY KADIRI
BIRTH CERTIFICATE
(o Oo JPá dt)o 1969, 12/17 Japsáw oá), esols 3a& 35 oo 33rá) soses 1999, 8/13 tod ocGayo
PRADESH REGISTRATION OF
BIRTHS &DEATHS ACT. 1969 AND RULE 8/13 OF THE ANDHRA
(SSUED UNDER SECTION 12/17 OF THE REGISTRATION OF
BIRTHS &DEATHS RULES 1999)
RECORD OF BIRTH WHICH IS THE REGISTER FOR
INFORMATION HAs BEEN TAKEN FROM THEORIGINAL ANDHRA PRADESH, INDIA.
THIS IS TO CERTIFY THAT THE FOLLOWING
KADIRIOF DISTRICT ANANTAPUR OF STATE/UNION TERRITORY
MUNICIPALITY KADIRI OF TAHSIL/BLOCK
Oorás / SEX: 3(/ FEMALE
/NAME: SATHARLA VARSHA SREE
Sb/ DATE OF BIRTH: s3 wS/PLACE OF BIRTH:
MOHAN NURSING HOME/35 SDyof s
03-03-2020
THIRD-MARCH-TWO THOUSAND TVWENTY
dot c /NAME OF FATHER:
d /NAME OF MOTHER: SATHARLA ANJINEYULU /OO soSaew
SATHARLACHANDANA /OO Sods
e96 so8),(/ FATHER'S AADHAAR NO:
estP5 soB),, / MOTHER'S AADHAAR NO: XXXXXXXX5265
us, OJrSS Ddár PERMANENT ADDRESs OP
XXXXXXXX6383
PARENTS AT THE T:ME d Sodew
Do o, o d doaew D P | ADDRESS OF PAXENTS:
OF BIRTH OF THE CHÍLD:
A KOTHA PALLJ , 6-65-A ,
AMADAGUR AKOTHA PALLI, 6-65-A, AMADAGUR,
ANANTAPUR. ANANTAPUR.
AMADAGUR. AMADAGUR, AMADAGUR, AMADAGUR, AMADAGUR, AMADAGUR.
ANDHRA PRADESH- 515556 ANDHRA PRADESH- 515556
S
esesocrdo,.6-65-es, es5dKP, es So 3 G-65-es, e9Sdo,
eoád6, ebobP6.
515556 - S1555G
S o b / DATE OF REGISTRATION:
SaPásos / REGISTRATION NUMBER: 10-03-2020
B-2020: 28-90074-000459
Jo5wew / REMARKS (IF ANY):
TOD: 5.33 PM
ay SU tsSodso ISSUING AUTHORITY :
a 3 / DATE OF ISSUE:
21-12-2021
REGISTRAR (BIRTH &DEATH)
MUNICIPALITY KADIRI
UPDATED ON
10-03-2020 00:00-00
"THIS IS ACOMPUTER 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".
3 asóbdu, (o aoónsa dögdoor 21 BaroT Srá) daboa / ENSURE REGISTRATION OF EVERY HIRTH AND DEATH
Sowg 1
NO. 1 GOVERNMENT OF ANDHRA PRADESH FORM-5
DEPARTMENT OF HEALTH, MEDICAL AND FAMILY WELFARE
GGH ANANTHAPUR
BIRTH CERTIFICATE
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE ANDHRA PRADESH
REGISTRATION OF BIRTHS &DEATHS RULES 1999)
THIS IS TO CERTIFY TH¤T THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF BIRTH WHICH IS THE REGISTER
FOR GGH ANANTHAPUR OF TAHSIL/BLOCK ANANTAPUR OF DISTRICT ANANTAPUR OF STATE/UNION TERRITORY ANDHRA PRADESH, INDIA.
d/ NAME:SATHARLA PRATHUSHA Ocnáw/SEX: 3FEMALE
d | DATE OF BIRTH. e U / PLACE OF BIRTH:
13-12-2017 GGH ANANTHAPUR
THIRTEENTH-DECEMBERTW0 THOUSAND SEVENTEEN
ÖU do/ NAME OF MOTHER: ow /NAME OF FATHER:
CHANDANA ANJANEYULU
s83 / MOTHER'S AADHAAR NO: 96 boà).( / FATHER'S AADHAAR NO:
Dc wyo ó does dOPá |ADDRESS OF PARENTS AT THE TIME OF ADDRESS OF PARENTS:
BIRTH OF THE CHILD:
AMADAGUR, ,AMADAGUR, ANANTAPUR, ANDHRA PRADESH
AMADAGUR, AMADAGUR, ANANTAPUR,
ANDHRA PRADESH
d oa / REGISTRATION NUMBER: - d / DATE OF RECISTRATION
B-2018: 28-15120-000165 08-01-2019
8083es /REMARKS (IF ANY):
t S 3e/ DATE OF ISSUE: zO ebEO odso ISSUING AUTHORITY
08-01-2018
UPDATED ON :
08-01-2018 [Link]
"THIS IS ACOMPUIER GENERATED CERTIFICAIE WHICH
THE GOVT OF INDIA VIDE CIRCULAR NO,CUNTAINS FACSIMILE SIGNATURt OF THE ISSUING AUTHORITY"
V/[Link](CRS) DATED 27ULY-2015 HAS
APPROVFD THIS CERTIFICATE AS AV'AI ID IECAL DOCUMENT FOR ALL OFFICIAL PURPOSES
p sáo, pß udaäo 8SJo 21 Uwro Jarco
aoot/ ENSURE KEGISTR\TION OF EVERY BIRTILAND
DEATIH"