Sample Birth Certificate from India in English





BHUJNAGARPALIKA

CERTIFICATE OF BIRTH
(Issued under Section 12/17 of the Registration of Birth and Death Act.
1969 and Rule-8 of Registratio of Birth & Death Rules, 2004)


GOVERNMENT OF GUJARAT
DEPARTMENT OF PUBLIC / HEALTH


This is to certify that the following information has been taken from the Original record of Birth which is in the register for Bhuj Nagarplika of the Bhuj of District Kachchh of State Gujarat, India

1.
Name:
2.
Sex(Male/Female):
3.
Date of Birth:

Time:
4.
Registration No.:

Regi. No.:    page No.:
5.
Place of Birth:
6.
Date of Registation:
7.
Mothers Name:
8.
Fathers Name:
9.
Address:
Note: Birth register has to be done within One year.




Date:


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