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Enquiry Birth Forms

The document outlines the format for an enquiry report of birth events, detailing required information such as date of birth, names of parents, place of birth, and literacy levels. It also includes sections for signatures of informants and witnesses, as well as a certification statement for delayed registration of births. This format is to be used for applications submitted after 30 days but within one year of the birth event.

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letsmailarnabghosh
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544 views1 page

Enquiry Birth Forms

The document outlines the format for an enquiry report of birth events, detailing required information such as date of birth, names of parents, place of birth, and literacy levels. It also includes sections for signatures of informants and witnesses, as well as a certification statement for delayed registration of births. This format is to be used for applications submitted after 30 days but within one year of the birth event.

Uploaded by

letsmailarnabghosh
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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ENQUIRY REPORT FORMAT OF BIRTH EVENTS

1. Date of Birth.......................................................................................................
2. Sex...................................
3. Name of the Child...............................................................................................
4. Name of Father....................................................................................................
5. Name of Mother..................................................................................................
6. Place of Birth........................................................................................................
7. Permanent Residential Address- At.....................................Po............................
Ps..........................................Dist.....................................State...........................
8. Religion................................................................................................................
9. Nationality..........................................................................................................
10. Literacy of Mother..............................................................................................
11. Literacy of Father................................................................................................
12. Order of Birth......................................................................................................
13. Name of Informant...............................................................................................
14. Signature of the Informants.................................................................................

WITTNESS Name Signature


1. AWW/ ASHA....................................................................................................................

2. Ward member/ Sarapanch...................................................................................................

3. Councillor/Chair Person/ Panchayatraj member..............................................................

This is to certify that...............................................................of Village................................


Po.......................................................PS............................................Dist....................................
State............................................is actually born on .............................at...................................

MPHW(M)
Gunupur Municipality

N.B:- This format should be attached along with the application for delayed
registration of Births & Deaths events after 30days within one year.

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