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BIRTH-CERTIFICATE-Application File

This document is an application form for a birth certificate. It requests information such as the date of birth, sex, name of child, names of parents, place of birth, number of copies needed, and whether the certificate should be delivered by courier. The applicant must provide their name, address, and telephone number. The application notes that a birth certificate will only be issued if the birth is registered in GHMC records.

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111 views1 page

BIRTH-CERTIFICATE-Application File

This document is an application form for a birth certificate. It requests information such as the date of birth, sex, name of child, names of parents, place of birth, number of copies needed, and whether the certificate should be delivered by courier. The applicant must provide their name, address, and telephone number. The application notes that a birth certificate will only be issued if the birth is registered in GHMC records.

Uploaded by

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

(Write in Capital Letters)

CIRCLE/LOCALITY :

1. Date Of Birth :

2. Sex :

3. Child Name :

Note: If Registered Mention the Child Name.


If Child Name not included a separate form 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
Hospital/Institute or the Address of the House where the Birth took place. If other
place give location)
a. Hospital/Institution Name :
b. House Address :
c. Other place :

7. No. Of Copies Required :


a. Do you want the Birth Certificate by Courier(Yes/No):
b. If Yes give Name and Address with Pin Code below:

Name & address, (Signature of the Applicant)

Telephone No:

Note:- Birth certificate will be issued subject to entry found Registered with GHMC
records.

For Office use:

Meeseva Transaction No: Transaction Date:

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