REPUBLIC OF KENYA
CERTIFICATE OF BIRTH A
3831556
Birth in the.........................................................................District in the .....................................Province
Entry Where
No. Born Name
Date of Sex
Birth Name and
Surname of Father
Name and Maiden
Name of Mother
Name and Description
Of Informant
Name of Registering Date of
Officer Registration
I………………………………………………………………………………………………………………………………………………………………………District/
Assistant
Registrar for……………………………………......…………………………………......……… District, hereby certify that this certificate is compiled
From an entry/return in the Register of Births in the District.
District/Assistant Registrar
Given under the Seal of the Director of Civil Registration on the ........................ day of ................................ 20........................
This certificate is issued in pursuance of the Births and Deaths Registration Act (CAP.149) which provides that a
Certified copy of any entry in any register or return purporting to be sealed or stamped with the seal of the Director
of Civil Registration shall be received as evidence of the dates and facts therein contained without any or other
proof of such entries.
GPK (SP) 7242- 50m Bks-5/2018