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Birth Application

This document is an application form for obtaining a birth certificate, requiring information such as the child's date of birth, name, and parents' names. It includes options for the place of birth and the number of copies needed, as well as a courier option for delivery. The issuance of the birth certificate is contingent upon the registration found in the birth records.

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meeseva2709
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31 views1 page

Birth Application

This document is an application form for obtaining a birth certificate, requiring information such as the child's date of birth, name, and parents' names. It includes options for the place of birth and the number of copies needed, as well as a courier option for delivery. The issuance of the birth certificate is contingent upon the registration found in the birth records.

Uploaded by

meeseva2709
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FOR BIRTH CERTIFICATE

(Write in capital letters)

1.DATE OF BIRTH

2.SEX

3.CHILD NAME

a)If Registered Mention the Child Name.

b)If Child Name not included a separate from to be filled by the Father and Mother of the child

4. Name of the Father

5.Name of the Mother

6. Place of Birth

(Tick the appropriate entry a,b,c below and give the name of the Hosipital/Inistitut eor the Adress of the
House where the Birth took place. If other place give location)

a)Hosipital/Institution Name

b)House Adress

c)Other place

7) .No Of Copies Required

8. a) Do you want the Birth Crtificate by Courier-Yes/No

b)If Yes Name and Adress with Pin Code

Name&address (Signature of the Applicant)

Telephone No

Note : Birth certificate will be issued subject to entry found Registered in BIRTH RECORDS-
C&DMA/PANCHYATS.

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