Birth of a Child

Imelda Hospital

Jl Banyuwangi No 45

Bandung 23213

Certificate of Recognition of Birth

Because of God’s help and grace, has been born safely in the Imelda Hospital Pematangsiantar boys from :

Mother’s Name           : Elita

Father’s Name             : Rudi

Occupation                  : Lecturer

Address                       : Jl. Singosari No 12 Bandung

Weight                        : 3 kg

Body Length               : 55 cm

Day                             : Tuesday

Date                            : 20 May 2018-05-23

Time                            : 03 am

Birth certificate is made to be used for the concerned as it should be.

Bandung, 20 May 2018-05-23

Doctor

Herlina