giay khai sinh ban chinh mau 2 7 2013
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No: 160
Book No: 01/2011
SOCIALIST REPUBLIC OF VIET NAM
Independence - Freedom – Happiness
BIRTH CERTIFICATE
(Original)
Full name: LE PHAN HOANG KY
Date, month, year of birth: May 20, 2011
Sex: Male
In words: The twenty of May, two
thousand and eleven.
Place of birth: Tu Du hopital, Ho Chi Minh city
Ethnic group: Kinh
Nationality: Vietnam
Full name of father: LE HOANG QUY
Ethnic group: Kinh
Nationality: Vietnam
Year of birth: 1984
Permanent/temporary residence: Loc Thanh hamlet, Loc Hung village, Trang Bang
district, Tay Ninh province.
Full name of mother: PHAN THI TUYET LAN
Ethnic group: Kinh
Nationality: Vietnam
Year of birth: 1990
Permanent/temporary residence: Loc Thanh hamlet, Loc Hung village, Trang Bang
district, Tay Ninh province.
Place of registration: PEOPLE’S COMMITTEE Loc Hung village, Trang Bang
district, Tay Ninh province.
Date of registration: June 8, 2011
Remarks:
Full name of the birth declarant: LE HOANG QUY
Relationship with the birth-declared person: father
Executer
(signed)
Tran Van Buot
THE SIGNER OF THE BIRTH CERTIFICATE
SIGN FOR THE CHAIRMAN
Vice-Chairman
(signed and stamped)
Nguyen Van Phuc
