| 1. |
Serial No. of Birth Register |
Date |
| 2. |
Name of Child |
|
| 3. |
Place of Birth,
Date and Hour |
Sex: Male |
|
Female |
|
| 4. |
Name of hospital/clinic and Doctor/midwife
who attended the deliver |
|
| 5. |
Name and address of Mother and her
National Identity Card No. or Nationality |
| 6. |
Name of Father and his National
Identity Card No. |
| 7. |
Religion, Caste and Nationality
of the Father |
| 8. |
Place of Residence and address of
the Father |
| 9. |
Occupation/Profession of the Father |
| 10. |
Name and Address of the Person Making
Report |
| 11. |
Date of Report |
|
Asstt. Admin. Officer
Deputy Director/Director
|
