Application Form For Request of Birth Certificate

Company Name(s): 

To
The District Registrar,
Births and Deaths,
District_________________.
Subject: - Request for Birth Certificate
Sir,
Kindly issue me_________copies of birth certificate as per particulars are given below:-
1. Date of Birth __________________________________________
2. Name of Child __________________________________________
3. Sex (Male/Female) __________________________________________
4. Place of Birth __________________________________________
5. Name of Father __________________________________________
6. Name of Mother __________________________________________
7. Permanent Address __________________________________________
8. Birth order __________________________________________
Thanking you,
Yours faithfully,
( )
Name _______________
Adderss _____________
Total amount of Rs._____________
Receipt No.____________________ Dated_________________