The Socialist Republic of Vietnam
Indtependence—Frecdes—Happincss
Resident's Commune
Commune: Dai 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
Nationality:
Baby's Parents Mother Father
Name Liao Qimei Lu jinqin
Ape 43 44
Nationality Han San Diu
Nationality Vietnam Vietnam
Occiupation Farmer Farmer
Address Dai Tian Nong Commune Dai Tian Nong Commune
Applicant's name age address
Name: Lu jinqin
Age: 44
Address : Dai Tian Nong Commune Quang He County Quang Ninh Province Vietnam.
Applicant's Signature: Lu jinqin Register Institution and Date: December 17, 1973
Resident's Commune
Signature:Cac
Resident's Commune(Seal):
December 17, 1973
Signature:Nguyen Chi Cac