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. Name Sex . Date of Birth . Place of Birth Name of Father Date.. • FORM NO. 7 ( See Rule 8 ) BIRTH CERTIFICATE ( Issued Under Section 12/17 ) •gær-för(ical areas) This is to certify that the following information has been taken from the original record of birth, which is the re . Of of District .... .... ..... . . .. of State of Orissa. Date of Registration ..........A.Q..:../.É..-..€S... . Name of Mother Permanent Address of parents 04m Registration No. Gertificate issued UIS 13 (3) of RBD Act. 1069 vide MC JÆflCER & Memo CORPORATION of Executive Magistrate am ur an •a.