Birth certificate form

PEOPLE’S COMMITTEE
Commune/Ward: Ninh Thang
District: Hoa Lu
Province/City: Ninh Binh
SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness
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Form: BTP/HT 2006-KS.1.a
No. 28
Vol. 01/2007


BIRTH CERTIFICATE
(ORIGINAL)
Full name: TRINH SON TUNG Sex: Male
Date of birth: 29.04.2007 (In words: Twenty Ninth April Two Thousand and Seven)
Place of birth: Ninh Thang, Hoa Lu, Ninh Binh
Ethnic group: Kinh Nationality: Vietnamese
Native place: Ninh Thang, Hoa Lu, Ninh Binh
Full name of father: TRINH KIM TUYEN
Ethnic group: Kinh Nationality: Vietnamese
Full name of mother: LE THI HONG
Ethnic group: Kinh Nationlity: Vietnamese
Full name of the declarant: TRINH KIM TUYEN
Relationship with one who is being declared: Birth father

Declarant’sign
TRINH KIM TUYEN

Registrar
NGUYEN VAN NAM

Registered on 07 May 2007
On behalf of People’s Committee
Chairman
Pp Chairman
Vice Chairman
(Signed)
NGUYEN XUAN DONG



True copy from Birth registration book
No. 1631 Vol. 01
Date: 09th November 2004
Pp Chairman
Vice Chairman
(Signed & sealed)
VU MANH THANG