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GOVERNMENT OF WEST BENGAL

LAW DEPARTMENT
OFFICE OF THE REGISTRAR GENERAL OF MARRIAGES
SCHEDULE - 'C'

CERTIFICATE OF REGISTRATION
[SEE SUB RULE (4) 15]
UNDER SUB-SECTION (1) OF SECTION 8 OF THE HINDU MARRIAGE ACT, 1955
Certificate No.: WB34500400010100002536-2022-187561 Date: 29-03-2023
The following is the extract of REGISTRATION OF MARRIAGE between the parties who made declaration
under clause (3) of sub-rule (4) of rule 15 of the West Bengal Hindu Marriage Registration Rules 2010.

Details of Husband Details of Wife


Name: BARUN MONDAL Name: PIYALI MONDAL

Father's Name: LATE BRIHASPATI MONDAL Father's Name: CHANDAN DAS


Mother's Name: PRATIMA RANI MONDAL Mother's Name: NANDITA DAS
Date of Birth: 10-06-1991 Date of Birth: 15-05-1999
Aadhaar No: **** **** 7403 Aadhaar No: **** **** 6576
Present Address: KUMARCHAK KHANJANCHAK, DIST- MIDNAPORE(PURBA), Present Address: BASUDEVPUR KHANJANCHAK, DIST- MIDNAPORE
PO- KHANJANCHAK, PS- DURGACHAK, WEST BENGAL, INDIA, PIN- 721602 (PURBA), PO- KHANJANCHAK, PS- DURGACHAK, WEST BENGAL, INDIA, PIN-
721602
Permanent Address: KUMARCHAK KHANJANCHAK, DIST- MIDNAPORE
(PURBA), PO- KHANJANCHAK, PS- DURGACHAK, WEST BENGAL, INDIA, PIN- 721602 Permanent Address: BASUDEVPUR KHANJANCHAK, DIST- MIDNAPORE
(PURBA), PO- KHANJANCHAK, PS- DURGACHAK, WEST BENGAL, INDIA, PIN-
721602

Signature: Signature:

Hindu Marriage Registrar Details:


ID: WB34500400010100002536 NAME: RAMPRASAD KUILA
OFFICE ADDRESS: VILL - BASUDEVPUR, PREMISES NO. 430/429,HALDIA,MIDNAPORE(PURBA),WEST BENGAL, INDIA,
PIN-721602
Social Marriage Details:
Date: 27-11-2022 Actual Place: MEGHDOOT HOTEL BASUDEVPUR, PS- DURGACHAK,PO- KHANJANCHAK,PIN- 721602,
DIST- MIDNAPORE(PURBA), WEST BENGAL, INDIA
Registration Details:
Date: 29-03-2023 Actual Place: VILL - BASUDEVPUR, PREMISES NO. 430/429,PS- DURGACHAK, PO- KHANJANCHAK, PIN-
721602, DIST- MIDNAPORE(PURBA), WEST BENGAL
Registration of the marriage effect from 27-11-2022
Corresponding Application (Schedule A) Serial No.: 2022-187561 Dated: 10-12-2022

Full signature of Hindu Marriage Registrar

Issued at Kolkata, West Bengal, India under Seal of Authority on this 29 day of, March (month), 2023 (year).

WB34500400010100002536 by OTP 91*98*17


Full Signature and LTI and addresses of three witnesses are as follows:

Name: PALAS PATRA Signature and LTI of


Witness:
Present DURGACHAK COLONY BLOCK C, HALDIA, PURBA
Address: MEDINIPUR, PIN-721602;P.S-DURGACHAK

Name: CHANDAN DAS Signature and LTI of


Witness:
Present BASUDEVPUR, KHANJANCHAK, PURBA MEDINIPUR, PIN-
Address: 721602;P.S-DURGACHAK

Name: MAHUYA JANA PATRA Signature and LTI of


Witness:
Present DURGACHAK, HALDIA, PURBA MEDINIPUR, PIN-
Address: 721602;P.S-DURGACHAK

Schedule of children (with date of birth) born within the marriage (if any):

NAME Date of birth Gender


NA NA NA

Office of the Registrar General of Marriages,WB


K.I.T. Building (4th Floor),
P-16, India Exchange Place Extension,
Kolkata- 700073, West Bengal,
India
[email protected]
[email protected]

Contact Details of Solemnising Marriage Officer


Phone No. -
E-mail ID - [email protected]

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