Panchayat:Repo18/vol2-page0412: Difference between revisions
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<center>To be filled by the Registrar</center> | <center>To be filled by the Registrar</center> | ||
Registration No.: Registration Date: | Registration No.: Registration Date:<br> | ||
Registration Unit:<br> | Registration Unit:<br> | ||
Town/Village: District:<br> | Town/Village: District:<br> | ||
Remarks (if any):<br><div style="text-align: right; direction: ltr; margin-left: 1em;">Name and Signature of the Registrar</div> | Remarks (if any):<br><div style="text-align: right; direction: ltr; margin-left: 1em;">Name and Signature of the Registrar</div> | ||
FORM No. 9 See Rule 12 | |||
This part to be added to the Still Birth Register | <center>'''FORM No. 9'''</center><center>[ See Rule 12]</center><center>'''STILL BiRTH REGISTER'''</center><center> '''STILL BiRTH REPORT'''</center><center> legal information </center> | ||
To be filled by the informant 1. Date of Birth: | Form No. 3<br> | ||
<center>This part to be added to the Still Birth Register</center> | |||
To be filled by the informant <br>1. Date of Birth: | |||
{{Create}} | {{Create}} |
Revision as of 11:43, 24 January 2019
Registration No.: Registration Date:
Registration Unit:
Town/Village: District:
Remarks (if any) Name and Signature of the Registrar.
Form No. 2
To be filled by the informant
1. Date of Death: (Enter the exact day, month and year the death took place e.g. 1.1.2000)
2. Name of the Deceased: (Full name as usually written)
2A. Permanent address of the deceased
2B. Name of Father/Husband
2C. Name of Mother
2D. Address of the deceased at the time of the death
3. Sex of the deceased: (Enter Male' or 'Female' do not use abbreviation)
4. Age of the deceased: (if the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 year of age, give age in months, and if below 1 month give age in completed number of days, and if below one day, in hours.)
5. Place of birth: (Tick the appropriate entry 1, 2 or 3 below and give the name of the Hospital/Institution or the address of the house where the death took place. If other place, give location.) 1. Hospital/ Name:
Institution
2. House Address:
3. Other Place
6. Informant's name:
Address:
(After completing all columns
1 to 17 informant will put date
and signature here:)
Date: Signature or left thumb mark of the informant
Registration No.: Registration Date:
Registration Unit:
Town/Village: District:
Remarks (if any):
Form No. 3
To be filled by the informant
1. Date of Birth:
ഈ താൾ 2018 -ലെ പഞ്ചായത്ത് റെപ്പോ നിർമ്മാണം യജ്ഞത്തിന്റെ ഭാഗമായി സൃഷ്ടിച്ചതാണ്. |