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Birth Card

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bhatiadeepak37
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8 views

Birth Card

Uploaded by

bhatiadeepak37
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BIRTH CARD

UHID/IPD No. …………….……

Note
1. Kindly take care while filling this form.
2. Form to be filled in CAPITAL LETTERS only.
3. Parent only should fill this form.
4. Name of mother, father and address should be filled as per legal record.
5. Baby name once edit will never change.
6. This information will be submitted to MCD, sub registrar office of birth & death.
7. The MCD Karol Bagh, New Delhi or can be downloaded online from the site www.mcdonline.nic.in North zone after
received message of birth registration. Online download birth certificate.
8. Any changes after registering the birth will require an affidavit, a copy of original ID and five working days.
9. All fields are mandatory to fill.

Baby Name: (Optional)……………………….…………….…………. Surname…………………....…………….…

Date of Birth : ………………………….. Time of Birth..….………….Hours Baby Gender…………………………


Father's Name :………………………………………………. Mother's Name :……………..……………………………………
Present Address :………………….…………………………………………………………………………………………………..
…………………………………………………………………………….…………….…………………………………...…………
Permanent Address :…………………………………………………………………..……………………………………………...
……………………………………………………………………………………….…………………………………………………
Occupation of Father :………………………………………….. Occupation of Mother :……………………………….……......
Religion :…………………………………………………………………………………………..……………………………….….
Father's Education :……………………..…………………...… Mother's Education :……………………………………….…...
Town or Village of Residence of the Mother (Residency Before Marriage)
A Name of the Town or Village
1-Town : ………………………………………. 2- Village :……………………………………....
B Name of the District :…………………………………………………………................................
C Name of State :………………………………………. Pin code :…………………………………..
Current Age of the Mother :……………………… Age of the Mother at the Time of Marriage :………………….…...
Number of Children born alive to the Mother so far including this child :………….………………………...…….…......

Father’s Mobile No.: ………………..……………… Mother’s Mobile No.: ………………………..……..

Father’s Aadhar No.: …………………..…………. Mother’s Aadhar No.: (Mandatory) …………………………………..……

DECLARATION
I hereby declare that the details furnished above are true and correct to the best of my knowledge. In case any of the above
information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
Full name :………………………… Signature of the informant :…………………….…………………………..………………..
E-mail address :………………………………………………………………………………….……………………………………

Date :…………………..…….
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