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Cbc d6h45dbj b4 Form

This document is an application for a birth certificate for a child named Othniel Baraka Mutisya, born on August 29, 2017, at Kenyatta National Hospital in Nairobi. The application is submitted by the father, Egil Mutisya Syengo, with a fee of 250.0, and includes details of both parents. The application is marked as new without amendment and is for official use only.

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annphacyber
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13 views

Cbc d6h45dbj b4 Form

This document is an application for a birth certificate for a child named Othniel Baraka Mutisya, born on August 29, 2017, at Kenyatta National Hospital in Nairobi. The application is submitted by the father, Egil Mutisya Syengo, with a fee of 250.0, and includes details of both parents. The application is marked as new without amendment and is for official use only.

Uploaded by

annphacyber
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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OFFICE OF THE PRESIDENT

CIVIL REGISTRATION SERVICES


APPLICATION FOR A BIRTH CERTIFICATE
CBC-D6H45DBJ

FORM B4 FEE: 250.0 DATE: THU 13 FEBRUARY 2025

TO BE COMPLETED IN CAPITAL LETTERS FOR OFFICIAL USE ONLY

TYPE OF APPLICATION NEW WITHOUT AMENDMENT


APPLICATION NUMBER
COUNTY OF BIRTH NAIROBI
PRINT DATE
EXACT PLACE OF BIRTH KENYATTA NATIONAL HOSPITAL
NAME OF REGISTERING OFFICER
NAME OF CHILD OTHNIEL BARAKA MUTISYA
RECORD CHECK BY
CHILD ABOVE 18? NO
ASSESSED BY
DATE OF BIRTH 29-08-2017
APPROVED BY
SEX OF THE CHILD MALE

ENTRY OR NOTIFICATION NUMBER

DETAILS OF FATHER AVAILABLE? YES

NAME OF THE FATHER EGIL MUTISYA SYENGO

ID NUMBER OF THE FATHER

DETAILS OF MOTHER AVAILABLE? YES

NAME OF THE MOTHER NDAKITHI MATUKU

ID NUMBER OF THE MOTHER

NAME OF THE GUARDIAN

ID NUMBER OF THE GUARDIAN

ADDRESS OF THE APPLICANT NAIROBI

SIGNATURE

APPLICANTS NAME EGIL MUTISYA SYENGO TELEPHONE NO +254729050683

DATE PRESENTED THU 13 FEBRUARY 2025 PICK UP LOCATION ACK BISHOP

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