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Get IN Karnataka Form-5

Village/town of taluk. district of Karnataka State. 1 g 2 AU Name. Sex 3 d z v j R 4 d z Date of Birth. A. Form - No. P lP P g GOVERNMENT OF KARNATAKA d v g tU R jf g g Chief Registrar of Births and Deaths d i t v d. C Ai 1969g 12/17 Ai P g t U P. d. Ai U 1999 g Ai 8/13 g g U P q z BIRTH CERTIFICATE Issued Under Section 12/17 of the RBDAct 1969 and Rule 8/13 of the KRBD Rules 1999 F P P Aq g u Ai P lP g d z f Ai v Q U / l t z jf j g d A Azs z z R Az v U z P Vz Ai Az i t P j Vz. A. Form - No* P lP P g GOVERNMENT OF KARNATAKA d v g tU R jf g g Chief Registrar of Births and Deaths d i t v d. C Ai 1969g 12/17 Ai P g t U P. d. Ai U 1999 g Ai 8/13 g g U P q z BIRTH CERTIFICATE Issued Under Section 12/17 of the RBDAct 1969 and Rule 8/13 of the KRBD Rules 1999 F P P Aq g u Ai P lP g d z f Ai v Q U / l t z jf j g d A Azs z z R Az v U z P Vz Ai Az i t P j Vz. This is to certify that the following information has been taken from the original record of birth which is the register for. Place of Birth 5 v Ai g 6 v Az Ai g Name of Mother Name of Father. 7 U d z Ai z v Az v Ai g 8 v Az v Ai g S Ai A Address of parents at the time of birth of the child Permanent address of parents 9 Az t AS Registration No*. 11 g Ai i z z g Ez 10 Az t Ai i z AP Date of Registration 12 i t v rz AP Remarks if any. 13 i t v P q P jAi Signature of Issuing Authority Date of Issue. Address of the issuing authority. g / Seal wAi Az d v g tz Az t Ai Rav r P Ensure registration of every birth and death of. C Ai 1969g 12/17 Ai P g t U P. d. Ai U 1999 g Ai 8/13 g g U P q z BIRTH CERTIFICATE Issued Under Section 12/17 of the RBDAct 1969 and Rule 8/13 of the KRBD Rules 1999 F P P Aq g u Ai P lP g d z f Ai v Q U / l t z jf j g d A Azs z z R Az v U z P Vz Ai Az i t P j Vz. This is to certify that the following information has been taken from the original record of birth which is the register for. Place of Birth 5 v Ai g 6 v Az Ai g Name of Mother Name of Father. 7 U d z Ai z v Az v Ai g 8 v Az v Ai g S Ai A Address of parents at the time of birth of the child Permanent address of parents 9 Az t AS Registration No*. 11 g Ai i z z g Ez 10 Az t Ai i z AP Date of Registration 12 i t v rz AP Remarks if any. 11 g Ai i z z g Ez 10 Az t Ai i z AP Date of Registration 12 i t v rz AP Remarks if any. 13 i t v P q P jAi Signature of Issuing Authority Date of Issue. Address of the issuing authority. 13 i t v P q P jAi Signature of Issuing Authority Date of Issue. Address of the issuing authority. g / Seal wAi Az d v g tz Az t Ai Rav r P Ensure registration of every birth and death of. Place of Birth 5 v Ai g 6 v Az Ai g Name of Mother Name of Father. 7 U d z Ai z v Az v Ai g 8 v Az v Ai g S Ai A Address of parents at the time of birth of the child Permanent address of parents 9 Az t AS Registration No*. 11 g Ai i z z g Ez 10 Az t Ai i z AP Date of Registration 12 i t v rz AP Remarks if any. 13 i t v P q P jAi Signature of Issuing Authority Date of Issue. Address of the issuing authority. .

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