(TRANSLATION) Thor.Ror. 1, Part 1 011306705541 Official Emblem 0 1 BIRTH CERTIFICATE Identification No.: Registration Office: Ratchathewi District 1037 1-1037-01426-55-1 1.1 Name : Surname : 1.2 Sex : 1.3 Nationality : [ 9 ][ 9 ] Male Female / [ 1 ] [ 2 ] Thai 1. Master Theetat Thunkijjanukij The Date of Birth: [ ][ ]-[ ][ ]-[ ][ ][ ] Time : Corresponding to the Day: Sunday Lunar Month : Year of the: Newborn Waxing Moon: the 4th 12 June 1994 15:49 hrs. Waning Moon: 7 Dog 1.5 Place of Birth : House No., Village No., Alley, Road, Sub-district, District, Province : Rajavithi Hospital Thung Phaya Thai Sub-district, Ratchathewi District, Bangkok Metropolis 1.6 Being the Child No. : 1.7 Birth Delivery Person: ○ Natural Delivery ○ Midwife ○ Other (specify): 1.8 Weight at Birth 1 ○ Nurse ○ Obstetrician ○ Physician 3, 100 grams 1.9 Name added to the House Registration No.: Village No., Alley, Road, Sub-district, District, Province: 10 Phaya Thai Road, Thung Phaya Thai Sub-district, Ratchathewi District, Bangkok Metropolis 1.10 House Code No. where the name is added : 1037-001480-4 2. 2.1 Name : Maiden Name : 2.2 Identification No.: Mother Aree Nontaprapantakorn 2.3 Age : 2.4 Nationality: [ ][ ] 2.5 Province of Birth : Country : 32 years ○ Thai ○ Other (specify): ……………………… Bangkok Metropolis Thailand 2.6 Address : House No., Village No., Alley, Road, Sub-district, District, Province, Country : 3. 3.1 Name : Surname : 3.2 Identification No.: Father Suriyon Thunkijjanukij 3.3 Age : 3.4 Nationality : [ ][ ] 3. Province of Birth: Country : 31 years ○ Thai ○ Other (specify): ……………………… Trang Thailand 3.6 Address : House No., Village No., Lane, Alley, Road, Sub-district, District, Province, Country : ○ Same as Mother's ○ Different 4. 4.1 Name : Surname: 4.2 Identification No.: 4.3 Age : Birth Mr. Sunthon Phetrung years Notifying 4.4 Address : House No., Village No., Lane, Alley, Road, Sub-district, District, Province : Person Rajavithi Hospital, Thung Phaya Thai Sub-district, Ratchathewi District, Bangkok Metropolis 4.5 Relationship to the Newborn ○ Head of Household ○ Father ○ Birth Delivery Person ○ Other (specify):……….. ○ Relative ○ Mother ○ Officer 4.6 Birth Certifying Document: 4.7 Birth Acknowledging Document: 4.8 Signature of Birth Notifying Person : ○ Yes ○ No ○ Yes ○ No Signature Signature of Birth Acknowledging Registrar Signature Certified correct translation: (Mrs. Somkhit Phatyen) Registrar: Assistant Local Registrar of Ratchathewi District Date of Birth Acknowledgment: 13 June 1994 [ ][ ]-[ ][ ]-[ ][ ] (Nootchanart Smathakarnagsorakij, Ph.D.) .