Sample Birth Registration

GOVT. OF THE PEOPLE'S REPUBLIC OF BANGLADESH

OFFIC OF THE SANITARY INSPECTOR

THANA  HEALTH COMPSEX PEROFPUR BANGLADESH.

BIRTH CERTIFICATE

1. SERIAL NO                                  : 02/02

2. NAME                                           : Md. Mizanur Rahman

3. DATE OF BIRTH                          : 1st April-1977

4. DATE OF REPORT OF BIRTH    : 15th April-1977

5. FATHER'S NAME                         : Abdul Mannan

6. MOTHER'S NAME                       : Late, Mrs. Momotaz Mannan

7. GRAND FADTHER'S NAME        : Late, Moklesur Rahman

8. PLACE OF BIRTH                        : Shikarpur, 

9. ADDRESS                                     : Shikarpur Water Supply Turn,

                                                           Shikerpur Road, Perojpur- 8500        

10. REPORTER OF BIRTH               : Abul Kalam Chowkidar                   

11. SEX                                             : Male

12. COMMUNITY                             : Muslim

13. NATIONALITY.                          : Bangladeshi

Md. Nurul Karim

Sanitary Inspector

Thana Health Complex

Perojpur