Birth Certificate Application

Fill in all details below. Once submitted, a formal printable application will be generated.

Registrar Information

District *

State *

Municipal Corporation / Panchayat

Registration Unit / Ward

Child’s Details

Full Name of Child *

Sex *

Date of Birth *

Time of Birth

Place of Birth *

Name of Hospital / Institution

Full Address of Birth Place *

City / Town / Village *

District *

State *

Birth Order (1st, 2nd, etc.)

Weight at Birth (in grams)

Father’s Details

Full Name *

Date of Birth

Age at Time of Child’s Birth

Aadhaar Number

Nationality *

Religion

Education Level

Occupation

Permanent Address *

Mobile Number *

Email Address

Mother’s Details

Full Name *

Maiden Name (Name Before Marriage)

Date of Birth

Age at Time of Child’s Birth

Aadhaar Number

Nationality *

Religion

Education Level

Occupation

Mobile Number

Permanent Address (if different from Father’s)

Informant Details

The informant is the person providing information for the birth registration (usually a parent or hospital authority).

Informant Name *

Relation to Child *

Aadhaar Number

Mobile Number *

Address *

Verification Details

Place of Signing *

Date of Application *

Type of Registration *

Print Options

Include Affidavit Section?

Yes No

Add Stamp Paper Space on First Page?

No Small (3 inches) Medium (5 inches) Large (7 inches)

✓ Copied to clipboard! Paste into MS Word.