Birth Registration

Still Birth Report

Application Number Application Status Date of Application
Date of Birth Registration Number Birth Report Category
Details Of Birth
Gender Father's Name Mother's Name
Father's Name(In Malayalam) Mother's Name(In Malayalam)
Place of Birth
Place of Birth Name of Institution Address of House
Circle Office* Address of House(In Malayalam)
Doctor's Name OP/IP Number
Applicant Details
Name of the Applicant Address of the Applicant
Residency Details of Parents
Rural/Urban Name of Rural Area Name of Urban Area
Country State
Statistical Details
Educational Qualification of Mother Mother's age at the time of Marriage Nursing received during delivery
Pregnancy Period (in weeks)
Remittance Details
Category of Application Fee to be Paid
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