(English Version) FORM NO-7/8

ISSUE NO : 395/2022

GOVERNMENT OF ODISHA
DEPARTMENT OF HEALTH AND FAMILY WELFARE
AIIMS HOSPITAL, BHUBANESWAR

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 AIIMS HOSPITAL, BHUBANESWAR of Tahasil BHUBANESWAR
of District KHORDHA of State ODISHA

21/03/2022
Date of Birth................................................................... AT-HIG-174,K-5 PHASE-2,
Permanent Address....................................................................
MALE
Sex.................................................................................... PO-KALINGA VIHAR, PS-TAMANDO, KHORDHA,
........................................................................................................
REYANSH RITHVIK PRADHAN
Name................................................................................ ODISHA, INDIA
...................................................................................................
SAROJ KUMAR PRADHAN
Name of Father.............................................................. AIIMS BHUBANESWAR,
Place of Birth................................................................................
SARITA RANI ROUT
Name of Mother............................................................. BHUBANESWAR(AIIMS HOSPITAL UNIT)
........................................................................................................
24/03/2022
Date Of Registration..................................................... 320/2022
Registration No............................................................................

Signature Not Verified

Digitally signed by DR
DR MADHUSMITA PADHIARY
MADHUSMITA PADHIARY
Date: 2022.04.29 12:07:16 IST
Issuing Authority
Reason: Birth Certificate
Location: Registrar, Births & Deaths
BHUBANESWAR(AIIMS
Date :29/04/2022 HOSPITAL Unit) AIIMS HOSPITAL, BHUBANESWAR
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.