(English Version) FORM NO-7/8
ISSUE NO : 595/2022
GOVERNMENT OF ODISHA
DEPARTMENT OF HEALTH AND FAMILY WELFARE
BIRASAL CHC
CERTIFICATE OF BIRTH
Issued under Section 12/17 of the Registration of Births and Deaths Act, 1969 and Rules of Odisha
Births and Deaths, Rule 2001
This is to certify that following information has been taken from the original records of birth which is in the
register for BIRASAL CHC of Tahasil KANKADAHAD
of District DHENKANAL of State ODISHA
14/03/2022
Date of Birth................................................................... KANTOL, KANTOL,
Permanent Address....................................................................
FEMALE
Sex.................................................................................... KANKADAHAD, DHENKANAL, ODISHA, INDIA
........................................................................................................
SAIPRATIKSHYA DEHURY
Name................................................................................ ...................................................................................................
BRAHMANANDA DEHURY
Name of Father.............................................................. KANKADAHADA GOVT. HOSPITAL ,
Place of Birth................................................................................
MAMATA PRADHAN
Name of Mother............................................................. KANKADAHADA , DHENKANAL
........................................................................................................
16/03/2022
Date Of Registration..................................................... 94/2022
Registration No............................................................................
Signature Not Verified
Digitally signed by
DR PRADEEP KUMAR JENA
DR.PRADEEP KUMAR JENA
Date: 2022.06.03 11:09:35
Issuing Authority
IST
Reason: Birth Certificate
Registrar, Births & Deaths
Date :03/06/2022 Location: BIRASAL BIRASAL CHC
Note: It is a digitally signed electronically generated certificate and therefore needs no ink-signed signature. This certificate is issued as per section 4,5&6 of Information Technology
Act 2000 and its subsequent amendments in 2008. For any query or verification, please visit https://www.birthdeath.odisha.gov.in Tampering of this certificate will attract penal action.
