Panchayat:Repo18/vol2-page0413
(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
Registration No. Registration
Date:
Registration Unit:
Town/Village: District:
Remarks: (if any):
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
1. Report for the Month of....... year..........
2.District:
3.Town/village:
4.Registration Unit:
5 Number of Births Registered: (a) Within one year of their Occurrence:
(b) After one year of their Occurrence:
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ഈ താൾ 2018 -ലെ പഞ്ചായത്ത് റെപ്പോ നിർമ്മാണം യജ്ഞത്തിന്റെ ഭാഗമായി സൃഷ്ടിച്ചതാണ്. |