The Socialist Republic of Vietnam
Independenceg—Frecdes—Happincss
Resident's Commune
Commune: Da Tian Nong
County: Quang He
Province:Quang Ninh
Bitrh Certificate
(Duplicate)
Name : Lu Yiying Male/Female: Female
Date of birth: December 17, 1973
Place of Birth : Dai Tian Nong Commune Quang He County Ninh Province
Nationali: San Diu
Baby's Parents Mother Father
Name Liao Qimei Lu jinqin
Age 43 44
Nationali Han San Diu
Nationality Vietnam Vietnam
Occiupation Farmer Farmer
Address Da Tian Nong Commune Da Tian Nong Commune
Applicant's name age address
Name: Lu jinqin
Age: 44
Address : Da Tian Nong Commune Quang He County Quang Ninh Province Vietnam.
Applicant's Signature: Lu jinqin Register Institution and Date: December 17, 1973
Resident's Committee
Signature:Cac
Resident's Committee (Seal):
December 17, 1973
Signature:Nguyen Chi Cac