Panchayat:Repo18/vol2-page0413

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(Enter the exact day, month and year e.g. 1.1.2000)
2. Sex: (Enter "Male' or 'Female' do not use abbreviation)
3. Name of the father: (Full name as usually written)
4. Name of the mother:(Full name as usually written)
5. Place of birth: (Tick the appropriate entry 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:
6. Informant's name:
Address: (After completing all columns
1 to 12 informant will put date
and signature here.)
Date:                                                                                                                                                              Signature or left thumb mark of the informant


To be filled by the Registrar

Registration No. Registration
Date: Registration Unit: Town/Village: District: Remarks: (if any): Name and Signature of the Registrar FORM No. 10 See Rule 13) NON-AVAILABILITY CERTIFICATE (issued under Section 17 of the Registration of Births & Deaths Act, 1969) This is to certify, that search has been made on the request of Shri/Smt/Kum.................. son/ wife/daughter of............. in the registration records for the year(s)........................ relating to (Local area)................................................................................................. of (Tahsil)..................................................................................................................................................... of (District)................................................. of (State)...................................................... and found that the event relating to the birth/death of .................................. Son/ daughter of........................................ was not registered. Date........................................ Signature of issuing authority Seal FORM No. 11 See Rule 14) SUMMARY MONTHLY REPORT OF BIRTHS Report for the Month of....... year.......... District: Town/village: Registration Unit: Number of Births Registered: (a) Within one year of their Occurrence: (b) After one year of their Occurrence:

വർഗ്ഗം:റെപ്പോയിൽ സൃഷ്ടിക്കപ്പെട്ട ലേഖനങ്ങൾ.