Birth Certificate Application

Birth Registration Details

Language *

Registration Unit Name *

Registration Unit Code *

Particulars of Child

Type of Registration *

First Name of Child *

Middle Name of Child

Last Name of Child

Sex of Child *

Date of Birth *

Time of Birth (Optional)

Weight at Birth (kg)

Birth Order (e.g., 1,2)

Name of Hospital/Institution where birth took place

Address of Hospital/Institution

Place of Birth Details

Country *

State *

District *

Sub District *

Town / Village *

Ward Number

Pincode

Police Station

Details of Father

Father's First Name *

Father's Middle Name

Father's Last Name

Aadhaar No.

Mobile

Occupation

Details of Mother

Mother's First Name *

Mother's Middle Name

Mother's Last Name

Aadhaar No.

Mobile

Occupation

Address of Parents at Time of Birth

Country *

State *

District *

Sub District *

Town / Village

Ward No.

Pincode

Police Station

Address Line *

Permanent Address of Parents

Country

State

District

Sub District

Town / Village

Ward No.

Pincode

Police Station

Permanent Address Line

Informant Details

Name of Informant *

Relation with Child *

Mobile

Address of Informant *

Aadhaar No. of Informant

Other Details

Duration of Pregnancy (weeks)

Delivery Attended By

Birth Registration No. (if any)

Remarks

Upload supporting documents (Aadhaar / Proof / Hospital certificate)

Click to upload files

Allowed: images and PDFs. Max files: 5. Max size per file: 10 MB.

Jhajha Nagar Parishad

Jhajha Nagar Parishad

Jhajha Nagar Parishad

Birth Certificate Application

Birth Registration Details

Particulars of Child

Place of Birth Details

Details of Father

Details of Mother

Address of Parents at Time of Birth

Permanent Address of Parents

Informant Details

Other Details

Upload supporting documents (Aadhaar / Proof / Hospital certificate)

Birth Certificate Application

Birth Registration Details

Particulars of Child

Place of Birth Details

Details of Father

Details of Mother

Address of Parents at Time of Birth

Permanent Address of Parents

Informant Details

Other Details

Upload supporting documents (Aadhaar / Proof / Hospital certificate)