जन्म पंजीकरण

Year : Registration No.* : Registration Date :
Date of Birth : Book No. :
Child Name* : Sex* :  Male Female Other
Mother Name* : Father Name* :
Place of Birth :
Informer Name* :
Informer Address* :
Mother Address:
District : State :
Religion : Issue Date :
Mother Qualification: Father Qualification:
Mother Profession: Father Profession:
At time of Child Birth Mother Father Address:
Mother Father Permanent Address:
Mother Age at time of Marriage: Mother Age at time of Child Birth: Total No. of Childrens Including Infant:
Labour Type : Child Weight: KG Pregnancy Period: Weeks