Panchayat:Repo18/vol2-page0411: Difference between revisions
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5A. Permanent address of the parents <br> | 5A. Permanent address of the parents <br> | ||
5B. Address of the parents at the time of birth of the child<br> | 5B. Address of the parents at the time of birth of the child<br> | ||
6. Place of birth: (Tick the appropriate entry 1 or 2 below | |||
and give the name of the Hospital/Institution or the address <br>of the house where the birth took-place) | and give the name of the Hospital/Institution or the address <br>of the house where the birth took-place)<br> | ||
1. Hospital/ Name:<br>Institution | 1. Hospital/ Name:<br>Institution<br> | ||
2. House        Address:<br> | 2. House Address:<br> | ||
7. Informant's name:<br>Address:<br> | |||
(After completing all columns 1 to 20, informant will put date and signature here.)<br> | (After completing all columns 1 to 20, informant will put date and signature here.)<br> | ||
Date: Signature of left thumb marks of the informant<br>---- | Date: Signature of left thumb marks of the informant<br> | ||
To be filled by the Registrar | ---- | ||
<center>To be filled by the Registrar</center> | |||
---- | ---- | ||
{{Create}} | {{Create}} |
Latest revision as of 11:18, 24 January 2019
മാതാവിന്റെ പേര്/Name of Mother ....................................... . . . . . . . . . . . . . . . . . . . . . . . . . .പിതാവിൻറെ /ഭർത്താവിൻറെ പേര്/ Name of Father/Husband................................... മരിച്ച വ്യക്തിയുടെ മരണസമയത്തെ മരിച്ച വ്യക്തിയുടെ സ്ഥിരമായ മേൽവിലാസം മേൽവിലാസം
Address of the deceased at the time of death Permenant address of deceased
............................................................. ..........................................................
രജിസ്ട്രേഷൻ നം/Registration No........... രജിസ്ട്രേഷൻ തീയതി/Date of Registration...................
Remarks (if any) .............................
നൽകുന്ന തീയതി/ Date if Issue..........................................
Form No. 1
To be filled by the informant
1. Date of Birth: (Enter the exact day, month and year the child was born e.g. 1.1.2000)
2.Sex: (Enter "Male or 'Female, do not use abbreviation)
3. Name of the child, if any: (if not named, leave blank)
4. Name of the father: (Full name as usually written)
5. Name of the mother: (Full name as usually written)
5A. Permanent address of the parents
5B. Address of the parents at the time of birth of the child
6. Place of birth: (Tick the appropriate entry 1 or 2 below
and give the name of the Hospital/Institution or the address
of the house where the birth took-place)
1. Hospital/ Name:
Institution
2. House Address:
7. Informant's name:
Address:
(After completing all columns 1 to 20, informant will put date and signature here.)
Date: Signature of left thumb marks of the informant
ഈ താൾ 2018 -ലെ പഞ്ചായത്ത് റെപ്പോ നിർമ്മാണം യജ്ഞത്തിന്റെ ഭാഗമായി സൃഷ്ടിച്ചതാണ്. |