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1 THE TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS RULES 2000 (As Amended upto 20.08.2019) Government of Tamil Nadu 2019
Transcript

1

THE TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS

RULES 2000

(As Amended upto 20.08.2019)

Government of Tamil Nadu

2019

2

THE TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS RULES 2000

ARRANGEMENTS OF RULES

Rules SubjectSection under

Which framed

1. Short title extent and commencement

2. Definitions

3. Period of Gestation 2(1) (g)

4. Submission of Reports 4(4)

5. Forms for giving information of births and deaths 8 or 9

6. Births or Deaths in a vehicle 8(1)

7. Notification and Form of Certificate 10(1)

8. Extracts of registration entries to be given 12

9. Authority for delayed registration and fee payable thereof 13(1)(2)(3)

10. Period for registration of name of the child 14

11. Correction or cancellation of entry in the register of births and

deaths

15

12. Form of Register 16

13. Fees and Postal Charges payable 17

14. Interval and forms of periodical returns 19(1)

15. Statistical report 19(2)

16. Conditions for compounding offences 23

17. The custody, production and transfer of registers and other records

kept by regards

30(2)(k)

18. Manner of payment of fees

Annexure

Forms 1 to 14B

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(Published in Tamil Nadu Government Gazette Extraordinary No.976

Part III, Section 1(a)

dated 29.12.1999, Page No.1 to 6)

NOTIFICATIONS BY GOVERNMENT

HEALTH AND FAMILY WELFARE DEPARTMENT

TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS RULES, 2000

(G.O.Ms.No. 528, Health and Family Welfare (AB-2), 29th December 1999)

No.SRO A-95(a)/99

In exercise of the powers conferred by section 30 of the Registration of Births and

Deaths Act, 1969 ( Central Act 18 of 1969) and in the suppression of the Tamil Nadu Births

and Deaths Registration Rules, 1977, the Governor of Tamil Nadu with the approval of the

Central Government hereby makes the following rules, namely:

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1. Short title, extent and commencement: (1) These rules may be called the Tamil NaduRegistration of Births and Deaths Rules, 2000.

(2) These rules shall extend to the whole of the State of Tamil Nadu.

(3) They shall come into force on the 1st January 2000.

2. Definitions:- In these rules, unless the context otherwise requires:

(a) “Act” means the Registration of Births and Deaths Act, 1969 (Central Act 18 of 1969)(b)“Form” means a Form appended to these rules,(c) “Government” means the State Government,

(d) “Section” means a section of the Act.(e) “Register” means Register of Births and Deaths.

3. Period of Gestation: The period of gestation for the purposes of clause (g) of sub-section(1) of section 2 shall be twenty-eight weeks.

4. Submission of report under sub-section (4) of section 4 :– 1 [The report under sub-section(4) shall be prepared in the prescribed format appended to these Rules and shall be submittedalong with the statistical report referred to in sub-section (2) of section 19, to the StateGovernment by the Chief Registrar for every year by the 31st July of the year following theyear to which the report relates].

5. Form for giving Information of births and deaths: (1) The information required to begiven to the Registrar under section 8 or section 9, as the case may be, shall be in 2[FormsNos.1, [1A]3,2 and 3] 2 for the Registration of a birth, adoption of child, death and still birthrespectively, herein after to be collectively called the reporting forms. Information, if givenorally shall be entered by the Registrar in the appropriate reporting form and the signature orthumb impression of the informant obtained.

(2) The part of the reporting form containing legal information shall be called as “LegalPart” and the part containing statistical information shall be called as “Statistical Part”.

(3) The information referred to in sub-rule (1) shall be given within twenty one days fromthe date of birth, death or still birth.

1. The expression were substituted for the expression “Form 16”2. The expression were substituted for the expression “Form 2, 3 and 4”

vide G.O.Ms.No.85 Health &Family Welfare (AB2)Department, dt.29.04.2003

3. The expression “Form 1A” included.vide G.O.Ms.No.226 Health &Family Welfare (AB2)Department, dt.06.08.2015.

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6) Birth or Death in a vehicle: (1) In respect of a birth or death in a moving vehicle, theperson in-charge of the vehicle shall give or cause to be given the information undersub- section (1) of Section 8 at the first place of halt.

Explanation : For the purpose of this rule, the term “Vehicle” means conveyance of any kindused on land, air or water and includes an aircraft, boat, ship, railway carriage, motor-car,motor – cycle, cart, tonga and rickshaw.

(2) In the case of deaths ( not falling under clauses (a) to (e) of sub-section (1) of section 8)in which an inquest is held, the officer who conducts the inquest shall give or cause to begiven the information under sub-section (1) of section 8.

7. Notification and Form of Certificate under section 10: (1) The certificate as to the causeof death required under sub-section (3) of section 10 shall be issued in 1[Form No.4 or 4A]and the Registrar shall, after making necessary entries in the Register of Births anddeaths, forward all such certificates to the Chief Registrar or the Officer specified by himin this behalf by the 10th of the month immediately following the month to which thecertificate relates

(2) Any person who performs the funeral ceremonies of a person dying in a local area withinthe jurisdiction of a municipality, panchayat or other local authority or any other area, shallwhenever required furnish to the Registrar such information as he possesses regarding theparticulars required for registration.

8. Extracts of registration entries to be given under section 12: (1) The extracts of particularsfrom the register relating to births or deaths to be given to an informant under section 12 shallbe in 2[Form No.5 or Form No. 6] as the case may be.

(2) In the case of domiciliary events of births and deaths referred to in clause (a) ofsub- section (1) of section 8, which are reported direct to the Registrar of Births and Deaths,the head of the house or household as the case may be, or in his absence, the nearest relativeof the head present in the house may collect the extracts of birth or death from the Registrarwithin 30 days of its reporting.

(3) In the case of domiciliary events of births and deaths referred to in clause (a) ofsub- section (1) of section 8 which are reported by persons specified by the StateGovernment under sub-section (2) of the said section, the person so specified shall transmitthe extracts received from the Registrar of Births and Deaths to the concerned head ofhouse, or household, as the case may be, or in his absence the nearest relative of the headpresent in the house within thirty days of its issue by the Registrar.

1. These expressions were substituted for the expressions “5 or 5A”.2. These expressions were substituted for the expressions “6 or 7”

vide G.O.Ms.No.85 Health &Family Welfare (AB2)Department, dt.29.04.2003

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(4) In the case of institutional events of births and deaths referred to in clauses (b) and (e) ofsub-section (1) of section 8, the nearest relative of the new born or deceased may collect theextract from the officer or person in-charge of the institution concerned within thirty days ofthe occurrence of the event of birth or death.

(5) If the extract of birth or death is not collected by the concerned person as referred to insub-rules (2) to (4) within the period stipulated therein, the Registrar or the officer or personin-charge of the concerned institution as referred to in sub-rule (4) shall transmit the same tothe concerned family by post within fifteen days of the expiry of the aforesaid period.

9. Authority for delayed registration and fee payable thereof under section 13: (1) Any birthor death of which information is given to the Registrar after the expiry of the period specifiedin rule 5, but within 30 days of its occurrence shall be registered on payment of a late fee of1[rupees one hundred]

(2) Any birth or death of which information is given to the Registrar after thirty days butwithin one year of its occurrence, shall in the case of the local authorities specified in column(1) of the Table below, be registered only with the written permission of the officers specifiedin the corresponding entries in column (2) thereof, on payment of a late fee of 2[rupees twohundred].

TABLELocal Authorities

(1)Officers

(2)Village Panchayat Village Panchayat PresidentTown Panchayat Executive OfficerCantonment -Do-Municipality CommissionerCorporation -Do-Neyveli Lignite Corporation Chief Health Officer

(3) 4[Any birth or death which has not been registered within one year of its occurrenceshall be registered by an order of the Executive Magistrate not below the rank of a RevenueDivisional Officer] and on payment of late fee of 3[rupees Five hundred].

(4) Any person aggrieved by any order made under sub-rule 2, by the officers specified incolumn (1) of the Table below may, within one month from the date of receipt of such order,prefer an appeal against such order to the authorities specified in the corresponding entries incolumn (2) thereof.

1. These words were substituted for the words “rupees Two”2. These words were substituted for the words “rupees Five”3. These words were substituted for the words “rupees Ten”4. These words were substituted for the wordsAny birth or death which has not been registered within year of its occurrence shall be registered by anorder of the “Judicial Magistrate or a Metropolitan Magistrate ”vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.2017

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TABLE

Local Authorities(1)

Officers(2)

Village Panchayat PresidentRevenue Divisional Officer

Executive OfficerRevenue Divisional Officer District Collector

Executive Officer, Cantonment -Do-

Commissioner of Municipality -Do-

District Collector Chief Registrar of Births andDeathsCommissioner of Corporation

Chief Registrar of Births and Deaths Government

Provided that the appellate authority may in its discretion allow further time notexceeding one month for preferring any such appeal if it is satisfied that the appellant hassufficient cause for not preferring the appeal in time.

10. Period for the purpose of Section 14: (1) Where the birth of any child had beenregistered without a name, the parent or guardian of such child shall, within 12 months fromthe date of registration of the birth of child, give information regarding the name of the childto the Registrar either orally or in writing.

Provided that if the information is given after the aforesaid period of 12 months butwithin a period of 15 years which shall be reckoned:

(i) in case where the registration had been made prior to the date of commencement ofthe Tamil Nadu Registration of Births and Deaths Rules, 2000 from such date, or

(ii) in case where the registration is made after the date of commencement of theTamil Nadu Registration of Births and Deaths Rules, 2000 from the date of suchregistration, subject to provisions of sub – section (4) of section 23.

1 [“Provided further that in cases, where the registration had been made prior to the dateof commencement of the Tamil Nadu Registration of Births and Deaths Rules, 2000 and theinformation regarding the name of the child is not given within the time-limit specified in thefirst proviso, for the purpose of taking action as laid down therein, the parent or guardian of thechild shall give the information regarding the name of the child to the Registrar within a furtherperiod of five years.”]

1. This proviso was added vide G.O.(Ms.) No.252 Health and Family Welfare(AB2) Department,dt 18.10.2016.

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the Registrar shall:

(a) if the register is in his possession forthwith enter the name in the relevantcolumn of the concerned form in the birth register on payment of a late fee of 1[rupees twohundred]

b) If the register is not in his possession and if the information is given orally, make areport giving necessary particulars, and, if the information is given in writing, forward thesame in the case of the local authorities specified in column (1) of the Table below to theofficers specified in the corresponding entries in column (2) thereof for making necessaryentry on payment of a late fee of 2[rupees two hundred]

TABLE

Local Authorities(1)

Officers(2)

Village Panchayat Village Panchayat President

Town Panchayat Executive Officer

Contonment -Do-

Municipality Commissioner

Neyveli Lignite Corporation Chief Health Officer

Corporation Commissioner

(2) The parent or the guardian, as the case may be, shall also present to the Registrar the copyof the extract given to him under section 12 or a certified extract issued to him under section17 and on such presentation the Registrar shall make the necessary endorsement relating tothe name of the child or take action as laid down in clause (b) of the 3[ first proviso] tosub-rule (1)

1. These words were substituted for the words “rupees five”2. These words were substituted for the words “rupees five”

vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.2017.

3. This expression was substituted for the expression “Provision”

vide G.O.(Ms.) No.252 Health and Family Welfare(AB2) Department, dt 18.10.2016.

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11. Correction or cancellation of entry in the register of births and deaths under section 15

(1) If it is reported to the Registrar that a clerical or formal error has been made in theregister or if such error is otherwise noticed by him and if the register is in his possession, theRegistrar shall enquire into the matter and if he is satisfied that any such error has been made,he shall correct the error (by correcting or canceling the entry) as provided in section 15 andshall in the case of local authorities specified in column (1) of the Table below send an extractof the entry showing the error and how it has been corrected to the officer specified in column(2) thereof.

TABLE

Local Authorities

(1)

Officers

(2)Village Panchayat Village Panchayat President

Town Panchayat Executive Officer

Contonment -Do-

Municipality Commissioner

Neyveli Lignite Corporation Chief Health Officer

Corporation Commissioner

(2) In the case referred to in the sub-rule (1) if the register is not in his possession, theRegistrar shall make a report to the officer specified in the table in sub-rule (1) and call for therelevant register and after enquiring into the matter, if he is satisfied that such error has beenmade, necessary correction.

(3) Any such correction as mentioned in sub-rule (2) shall be countersigned by the officerspecified in the Table in sub-rule (1) in this behalf when the register is received from theRegistrar.

(4) If any person asserts that any entry in the register of births and deaths is erroneous insubstance, the Registrar may correct the entry in the manner prescribed under section 15 uponproduction by that person a declaration setting forth the nature of the error and true facts ofthe case made by two credible persons having knowledge of the facts of the case.

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(5) Not withstanding anything contained in sub-rules (1) and (4), the Registrar shall make areport of any correction of the kind referred to therein giving necessary details to the officerspecified in the table in sub-rule (1).

(6) If it is proved to the satisfaction of the Registrar that any entry in the register of births anddeaths has been fraudulently or improperly made, he shall make a report giving necessarydetails to the officer authorized by the Chief Registrar by general or special order in thisbehalf under section 25 and on hearing from him take necessary action in the matter.

(7) In every case in which an entry is corrected or cancelled under this rule, intimation thereofshould be sent to the permanent address of the person who has given information undersection 8 or section 9.

12. Form of register under section 16 :– 1[(1) The legal part of the [Form Nos. 1, 2 and 3shall be the Form No. 7, 8 and 9 and shall constitute the birth register, death register and stillbirth register respectively.]

(2) From 1st January of each calendar year new registration number starting from 1should be followed and continues till 31st December of that year.

(3) An event which occurred in any previous year reported during the current yearshall be recorded in the current year register only.

(4) A control register in 2[Form No.14A] shall be maintained by the Tahsildar towatch receipt of returns from all registration units in the area and dispatch of the same to theChief Registrar or to the officer specified by him in this behalf.

1. These words were substituted for the words“The Legal Part of Form 2, 3 and 4 shall be Form 8,9 and 10 and shall constitute the Birth

Register, Death Register and Still Birth Register respectively.2. The expression was substituted for the expression ‘Form 15’

vide G.O.Ms.No.85 Health& Family Welfare (AB2) Department, dated.29.04.2003

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13. Fees and postal charges payable under section 17: – (1) The fees payable for a searchto be made, an extract or a non-availability certificate to be issued under section 17 shall be asfollows –

Rs.1 [(a) Search for a single entry in the first year for which the search is made 100/-

(b) For every additional year for which the search is continued 100/-(c) For granting extract relating to each birth or death 200/-(d) For every additional copies of extract 200/-(e) For granting non-availability certificate 100/-]

Provided that no fee shall be payable by any officer of the Government of Tamil Naduor by any member of the staff of Estate duty circles duly authorized by their officers or byany person duly authorized by the District Soldiers, Sailors and Airmen’s Board for searchingor for obtaining an extract or for giving non-availability certificate of birth or death from anyregistrar for a bonafide public purpose, including the investigation of pension claims fromfamilies of deceased Indian Military Personnel.

(2) Any such extract in regard to a birth or death shall be issued in 2[Form No.5 or inForm No.6] as the case may be and shall be certified in the manner provided for in section 76of the Indian Evidence Act, 1872, (Act 1 of 1872), in the case of local authorities specified incolumn (1) of the table below by the Registrar or the Officers specified in the correspondingentries in column (2) thereof:

TABLELocal Authorities (1) Officers (2)

Village Panchayat

Town Panchayat

Village Panchayat President and Executive Officer (tillthe expiry of two years after the close of the calendar year towhich the register relates).Sub-Registrar of Assurance (after the expiry of two years).

Contonment Executive OfficerMunicipality CommissionerCorporation -Do-Neyveli Lignite Corporation Chief Health Officer

(3) If any particular event of birth or death is not found registered, the Registrar or theofficers specified in column 2 of the Table under sub-rule 2 shall issue a non-availabilitycertificate in 3[Form No.10].

(4) Any such extracts or non-availability certificate may be furnished to the personasking for it or sent to him by post on payment of the postal charges there for.

1.The expression were substituted for the expression(a) search for a single entry in the first year for which the search is made Rs.2.00/-(b)for every additional year for which the search continued Rs.2.00/- (c) for granting extract relating to

each birth or death Rs.5.00/-(d) for granting non-availability certificate of birth or death Rs.2.00/-

vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.20172. The expression was substituted for the expression

“Form No.6 or in Form No.7”3. The expression was substituted for the expression

“Form No.11”vide G.O.Ms.No.85 Health& Family Welfare (AB2)Dept, dated.29.04.2003.

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14. Interval and forms of periodical returns under sub-section (1) of section 19 :–

1[(1) Every Registrar shall after completing the process of registration send all the statisticalparts of the reporting forms relating to each month along with a summary monthly report inForm No.11 for Birth, Form No.12 for deaths, and Form No.13 for Still Births to the

Chief Registrar or the officer specified by him in this behalf on or before the 5th

of thefollowing month].

(2) The officer so specified shall forward all such statistical parts of the reporting formsreceived by him to the Chief Registrar or the officer specified by him, not later than 10th of thatmonth.

15. Statistical report under sub-section (2) of section 19: 2[The Statistical report undersub- section (2) of section 19 shall contain the tables in the prescribed formats appended to theserules and shall be compiled for each year before the 31st July of the year immediately followingand shall be published as soon as may be thereafter but in any case not late that five months fromthat date].

16. Conditions for compounding offences under section 23 :– (1) Any offence punishableunder section 23 may, either before or after the institution of criminal proceeding under thisAct, be compounded by an officer authorized by the Chief Registrar by a general or specialorder in this behalf, if the officer so authorized is satisfied that the offence was committedthrough inadvertence or oversight or for the first time.

(2) Any such offence may be compounded on payment of such sum, not exceedingrupees fifty for offences under sub-sections (1), (2) and (3) and rupees ten for offences undersub-section (4) of section 23 as the said officer may think fit.

1. These words were substituted for the words“Every Registrar shall after completing the process of registration send all the statistical part of thereporting forms relating to each month along with a summary monthly report in form 12, 13 and 14 tothe Chief Registrar or the office specified by him in their behalf on or before the 5th of the followingmonth.

2. These words were substituted for the words

The statistical report under Sub-section (2) of section 19 shall be in Form 16 and shall be compiled foreach year before the 31st July of the year immediately following shall be published as a Governmentpublication in the form of a booklet as soon as may be thereafter but in any case not later than fivemonths from that date.vide G.O.Ms.No.85 Health& Family Welfare (AB2)Department, dated.29.04.2003

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17. Registers and other records under section 30 (2) (k):- (1) The birth register, deathregister and still birth register shall be records of permanent importance and shall not bedestroyed.

(2) The orders of the specified authorities granting permission for delayed registrationreceived under section 13 by the Registrar shall form an integral part of the birth register,death register and still birth register and shall not be destroyed.

(3) The certificate as to the cause of death furnished under sub-section (3) ofsection 10 shall be retained for a period of at least 5 years by the Chief Registrar or the officerspecified by him in this behalf.

(4) Every birth register, death register and still birth register shall be retained by theRegistrar in his office for a period of twelve months after the end of the calendar year to whichit relates and such register shall thereafter in the case of the local authorities specified in thecolumn (1) of the Table below be transferred for safe custody to the officers specified in thecorresponding entries in column (2) thereof.

TABLE

Local Authorities(1)

Officers(2)

Village Panchayat

Town Panchayat

Village Panchayat President andExecutive Officer (till the expiry of two yearsafter the close of the calendar year to which theregister relates).

Sub-Registrar of Assurance (after theexpiry of two years).

Contonment Executive Officer

Municipality Commissioner

Corporation -Do-

Neyveli Lignite Corporation Chief Health Officer

18. Manner of payment of fees:- All fees payable under the Act may be paid in cash ormoney order or postal order.

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ANNEXURE

(See Rule 4)REPORT ON THE WORKING OF THE ACT

1. Brief description of State, its boundaries and revenue districts.

2. Changes in Administrative Areas.

3. Explanation about the differences in Areas.

4. Changes in Registration Area – Extension.

5. Administrative set up of the registration machinery at various levels.

6. General response of the public towards this Act.

7. Notification of births and deaths.

8. Progress in the Medical Certification of Cause of Death.

9. Maintenance of Records.

10. Search of births and deaths register for issue of certificates.

11. Delayed registrations.

12. Prosecutions and compounding of offences.

13. Difficulties encountered in implementation of the Act.

(i) Administrative.

(ii) Others.

14. Orders and Instruction issued under the Act.

15. General remarks.

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FORM NO. 1Form No.1 Birth Report

Legal InformationThis part to be added to the Birth Register

(See Rule 5)BIRTH REPORT FORMStatistical Information

This part to be detached and sent for statistical processing

In the case of multiple births, fill in a separateform for each child and write ‘Twin birth’ or‘Triple birth’ etc., as the case may be, in the

remarks column in the box below leftTo be filled by the informant1. Date of Birth: ____________________________

(Enter the exact day, monthand year the child was born e.g.1-1-2000)

2. Sex : ___________________(Male/Female/Transgender)do not use abbreviation)

3. Name of the child, if any: ______________________(If not named, leave blank)

4. Name of the father : __________________________(Full name as usually written)UID No of Father (if any)

5. Name of the Mother: _________________________(Full name as usually written)UID No of mother (if any)

6. Address of parents at thetime of Birth of the Child ____________________________________________________________________________

7. Permanent address of parents : ________________________________________________________________________

8. Place of Birth : _____________________(Tick the appropriate entry 1 or 2 below and givethe name of the Hospital/Institution or the address ofthe house where the birth took place)

1. Hospital / Institution Name & ___________________Address ________________________________________

2. House Address: ________________________________3. Others ________________________________

9. Informant’s name: ________________________________Address: ________________________________

(After completing all columns 1 to 22, informant will putdate and signature here:)Date: Signature or

left thumb mark of the informant

To be filled by the informant10. Town or Village of Residence of the mother:

(Place where the mother usually lives. This can bedifferent from the place where the delivery occurred.The house address is not required to be entered.)

a) Name of the Town / Village: ______________________b) Is it a town or village: (Tick the appropriate entry

below)1. Town 2. Village

c) Name of District: ________________________________

d) Name of State: ________________________________

11. Religion of the Family : (Tick the appropriate entrybelow)

1. Hindu 2. Muslim 3. Christian4. Any other religion: (Write the name of the

religion)

12. Father’s level of education : ______________________(Enter the completed level of education e.g. ifstudied upto class VII but passed only class VI,write class VI)

13. Mother’s level of education : ______________________(Enter the completed level of education e.g. ifstudied upto class VII but passed only class VI,write class VI)

14. Father’s Occupation: ____________________________(If no occupation write ‘Nil’)

15. Mother’s Occupation: ____________________________(If no occupation write ‘Nil’)

To be filled by the informant

16. Age of the mother (in completed years)at the time of marriage: ____________(If married more than once, age at first

marriage may be entered)

17. Age of the mother (in completed years)at the time of this birth :

18. Number of children born alive to themother so far including this child :(Number of children born alive toinclude also those from earliermarriage(s), if any)

19. Type of attention at delivery : (Tick theappropriate entry below)

1.Institutional – Government2.Institutional – Private or Non-

Government3.Doctor, Nurse or Trained midwife4.Traditional Birth Attendant5.Relatives or others

20. Method of Delivery : (Tick theappropriate entry below)1. Natural2. Caesarean3. Forceps/Vaccum

21. Birth Weight (in kgs.) (if available) :

22. Duration of pregnancy (in weeks) :

(Columns to be filled are over. Now putsignature at left)

To be filled by the RegistrarRegistration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

To be filled by the RegistrarName Code No.District:Taluk:Town/Village:Registration Unit:

To be filled by the RegistrarRegistration No: Registration Date:Date of Birth:Sex: 1. Male 2. Female 3. TransgenderPlace of Birth: 1.Hospital/Institution 2. House

Name and Signature of the Registrar

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FORM NO. 2 (See Rule 5)Form No.2 Death Report

Legal InformationThis part to be added to the Death Register

Form No.2This part to be detached and sent for statistical processing

Death Report(Statistical Information)

Form No.2

To be filled by the informant1. Date of Death: ___________________________

(Enter the exact day, monthand year the death took place) (e.g.1.1.2000)

2. Name of the Deceased: _______________________(Full name as usually written)UID No of deceased (if any)

3. Sex of the deceased: _________________________Male/Female/Transgender(do not use abbreviation)

4. Name of the Mother: _______________________________UID No of mother (if any)

5. Name of the Father: _________________________________UID No of Father (if any)

5.a. Name of Husband/Wife: ______________________________UID No of Husband/Wife (if any)

6. Age of the deceased: __________________________________(If the deceased was over 1 year of age, give age in completed years.If the deceased was below 1 year of age, give age in months, and ifbelow 1 month give age in completed number of days, and if belowone day, in hours)7. Address of the deceased at the time of death:_____________

________________________________________________________8. Permanent address of the deceased: _____________________

________________________________________________________9. Place of death: ________________________

(Tick the appropriate entry 1,2, or 3 below and give the nameof the Hospital / Institution or the address of the house wherethe death took place. If other place, give location)

1. Hospital / Institution Name:___________________& Address : ___________________________________

2. House Address: ______________________________3. Other place __________________________________

10. Informant’s name: _____________________________________Address: _______________________________________________(After completing all columns 1 to 21, informant will put dateand signature here:)

Date: Signature or left thumb mark of the informant

To be filled by the informant

11. Town of Village of Residence of the deceased:(Place where the deceased actually lived. This can bedifferent from the place where the death occurred. Thehouse address is not required to be entered.)

a) Name of Town / Village:b) Is it a town or village:

(Tick the appropriate entry below)2. Town 2. Village

c) Name of District:d) Name of State:

12. Religion: (Tick the appropriate entry below)

2. Hindu 2. Muslim 3. Christian

4. Any other religion: (Write the name of the religion)

13. Occupation of the deceased:(If no occupation write ‘Nil’)

14. Type of medical attention received before death:(Tick the appropriate entry below)

1. Institutional

2. Medical attention other than institution

3. No Medical attention

To be filled by the informant

15. Was the cause of death medically certified?(Tick the appropriate entry below)1. Yes 2. No

16. Name of Decease or Actual Cause of Death:(for all deaths irrespective of whethermedically certified or not)

17. In case this is a female death, did the deathoccur while pregnant, at the time of deliveryor within 6 weeks after the end of pregnancy:(Tick the appropriate entry below)

1. Yes 2. No.

18. If used to habitually smoke –for how many years?

19. If used to habitually chew tobacco in anyform –For how many years?

20. If used to habitually chew arecanut in anyform (including pan masala)-for how many years?

21. If used to habitually drink alcohol-for how many years?

(Column to be filled are over, Now put signatureat left)

To be filled by the RegistrarRegistration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

To be filled by the RegistrarName Code No.District:Taluk:Town/Village:Registration Unit:

Registration No: Registration Date:Date of Death:Age: Years/months/days/hoursSex: 1. Male 2. Female 3.TransgenderPlace of Death: 1. Hospital/Institution

2. House 3.Other placeName and Signature of the Registrar

17

FORM NO. 3Form No.3

Still Birth ReportLegal Information

This part to be added to the Still Birth Register

FORM NO. 3 FORM NO. 3STILL BIRTH REPORT FORM (See Rule 5)

Statistical InformationThis part to be detached and sent for statistical processing. In the case ofmultiple births, fill in a separate form for each child and write ‘Twin birth’etc, as the case may be, in the remarks column in the box below left.

To be filled by the informant1. Date of Birth: ________________________________

(Enter the exact day, monthand year) (e.g.01-01-2000)

2. Sex : ____________________Male/Female/Transgender)do not use abbreviation)

3. Name of the father : ________________________(Full name as usually written)UID No of father (if any)

4. Name of the mother: __________________________(Full name as usually written)UID No of Mother (if any)

5. Place of Birth : (Tick the appropriate entry below andgive the name of the Hospital/Institution or theaddress of the house where the birth took place)

1. Hospital / Institution Name &_________________Address: ______________________________________

2. House Address: _______________________________

5.a. Permanent address of parents : ____________________________________________________________________

5.b. Address of parents at thetime of Still Birth of the Child _______________________________________________________________________

6. Informant’s name: _______________________________Address: ________________________________________

(After completing all columns 1 to 12, informant will putdate and signature here:)

Date: Signature or left thumb mark of the informant

To be filled by the informant

7. Town or Village of Residence of the mother:(Place where the mother usually lives. This can be different from the place where the deliveryoccurred. The house address is not required to be entered.)

a) Name of Town / Village:b) Is it a town or village: (Tick the appropriate entry below)

1. Town 2. Villagec) Name of District:

d) Name of State:

8. Age of the mother (In completed years)at the time of this birth :

9. Mother’s level of education :(Enter the completed level of education e.g. if studied upto class VII but passed only class VI, writeclass VI)

10. Type of attention at delivery : (Tick the appropriate entry below)

1. Institutional – Government2. Institutional – Private or Non- Government3. Doctor, Nurse or Trained midwife4. Traditional Birth Attendant5. Relatives or others

11. Duration of pregnancy : (in weeks)

12. Cause of foetal death : (if known)

(Columns to be filled are over. Now put signature at left)

To be filled by the RegistrarRegistration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

To be filled by the Registrar

Name Code No.District:Taluk:Town/Village:Registration Unit:

Registration No: Registration Date:Date of Birth:Sex: 1. Male 2. Female 3. TransgenderPlace of Birth:1.Hospital/Institution 2.House

Name and Signature of the Registrar

18

Form No.1A(See Rule 5)

Form No. 1-ABirth Report for Adopted Child

Legal Information(This part to be added to the Birth Register)

Form No.1-ABirth Report for Adopted Child

Statistical Information(This part to detached and sent for statistical processing)

To be filled by the informant1*. Date of Birth: _____________________________

(if known, write exact date of birth)(Otherwise record the date of birth as ascertained by the Magistrate)

2*. Sex : ___________________________(Enter “Male or Female)Do not use abbreviation

3. Name of the Child: _______________________________(If name is changed on adoption, write new name)

4*. Name of the Mother:(If known) _______________________UID Number of Mother (if any)

5*. Name of the Father:(If known) ________________________UID Number of Father(if any)

6. Date and number of adoption deed / order: ___________________7. Name of the adoptive mother:

UID Number of adoptive mother(if any)

8. Name of the adoptive father:UID Number of adoptive father (if any)

9. Address of adoptive parents as recorded in Adoption deed:__________________________________________________________________

10. Permanent address of adoptive parents : __________________________________________________________________________________________

11*. Place of birth ___________________________________________________12. If adoption through agency write the place and address

Of the Adoption agency __________________________________________13. Informant’s name and address: __________________________________

__________________________________(After completing all columns 1 to 18 informant will put date andsignature here)*As contained in the original birth certificate.

Date Signature or left thumb mark of the informant

To be filled by the informant

14. Religion of the adoptive Father: (Tick the appropriate entry below)1. Hindu 2. Muslim 3. Christian

15. Adoptive Father’s level of education:(Enter the completed level of educatione.g. if studied upto class VII but passedonly class VI, write class VI)

16. Adoptive Mother’s level of education:(Enter the completed level of educatione.g. if studied upto class VII but passed only classVI, write class VI)

17. Adoptive father’s occupation(if no occupation write ‘Nil’)

18. Adoptive mother’s occupation:(If no occupation write ‘Nil’)

(Columns to be filled are over, Now put signature at left)

To be filled by the RegistrarRegistration No: Registration Date:Registration UnitTown/ Village District:Remarks:(If any)

Name and Signature of the Registrar

To be filled by the RegistrarName Registration No. Registration Date:District: Date of BirthTaluk:Town/ Village : Sex:1. Male 2. FemaleRegistration Unit: Place of Birth:Code No: Name and Signature of the Registrar

19

FORM NO.4(See Rule 7)

MEDICAL CERTIFICATE OF CAUSE OF DEATH(Hospital in patients. Not to be used for stillbirths)

To be sent to Registrar along with From No.2 (Death Report)

Name of the Hospital: ............................................................................I hereby certify that the person whose particulars are given below died in the hospital inward No………………… on ……………….. at ……………… A.M./P.M

NAME OF DECEASED For use ofStatistical

OfficeSex

Age at DeathIf 1 year ormore, age inyears

If less than 1year, age inMonths

If less than onemonth, age in days

If less than oneday, age in Hours

1. Male2. Female

CAUSE OF DEATH

I. Immediate causeState the disease, injury or complicationwhich Caused death, not the mode of dyingsuch as Hear failure, asthenia, etc.

Antecedent causeMorbid conditions, if any, giving rise to theabove Cause, stating underlying conditionslast

II.

Other Significant conditions contributing to theDeath but not related to the diseases or conditionscausing it.

(a) …………………due to (or asconsequences of)

(b)………………….due to (or as

consequencesof)(c)..........................

..............................

..............................

Interval betweenonset & deathApprox

……………………..

……………………..

……………………..

……………………..

……………………..

………………

………………

………………

……………..

……………..

Manner of Death1. Natural 2. Acident 3. Suicide 4. Homicide5. Pending Investigation

How did they injury occur?

If deceased was a female, was pregnancy the deathassociated with?If yes, was there a delivery? 1. Yes 2. No

1. Yes 2. No

Name and Signature of the Medical Attendant certifying the Cause of Death.Date of Verification:………………………………………………………………………….

SEE REVERSE FOR INSTRUCTIONS

(To be detached and handed over to the relative of the deceased)

Certified that Shri/Smt/Kum............................................... S/W/D of Shri………………………R/O…………………………………………………………. was admitted to this hospital on…………….and expired on …………………………………………….

Doctor:…………………………………..(Medical Supdt.Name of Hospital)

20

MEDICAL CERTIFICATE OF CAUSE OF DEATHDirections for completing the form

Name of deceased: To be give in full. Do not use initials. If deceased is an infant, not yet named at timeof death, write ‘Son of (S/o)’ or ‘Daughter of (D/o)’, followed by names of mother and father.

Age: If the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 yearof age, give age in months and if below 1 month give age in completed number of days, and if below oneday, in hours.

Cause of Deaths: This part of the form should always be completed by the attending physicianpersonally.

The certificate of cause of death is divided into two parts, I and II. Part I is again divided into three parts,lines (a) (b) (c). If a single morbid condition completely explains the deaths, then this will be written online (a) of Part I, and nothing more need be written in the rest of Part I or in Part II, for example, smallpox,lobar pneumonia, cardiac beriberi, are sufficient cause of death and usually nothing more is needed.

Often, however, a number of morbid conditions will have been present at death, and the doctor must thencomplete the certificate in the proper manner so that the correct underlying cause will be tabulated.First, enter in Part I(a) the immediate cause of death. This does not mean the mode of dying, e.g., heartfailure, respiratory failure, etc. These terms should not be appear on the certificate at all since they aremodes of dying and not causes of death. Next consider whether the immediate cause is a complication ordelayed result of some other cause. If so, enter the antecedent cause in Part I, line(b). Sometimes therewill be three stages in the course of events leading to death. If so, line (c) will be completed. Theunderlying cause to be tabulated is always written in last in Part I.

Morbid conditions or injuries may be present which were not directly related to the train of events causingdeath but which contributed in some way to the fatal outcome. Sometimes the doctor finds it difficult todecide, especially for infant deaths, which of several independent conditions was the primary cause ofdeath; but only one cause can be tabulated, so the doctor must decide. If the other diseases are noteffects of the underlying cause, they are entered in Part II.

Do not write two or more conditions on a single line. Please write the names of the diseases (in full) in thecertificates as legibly as possible to avoid the rise of their being misread.

Onset: Complete the column for interval between onset and death whenever possible, even if veryapproximately, e.g., “from birth” “several years”.

Accidental or violent deaths: Both the external cause and the nature of the injury are needed andshould be stated. The doctor or hospital should always be able to describe the injury, stating the part ofthe body injured, and should give the external cause in full when this is shown. Example: (a) Hypostaticpneumonia; (b) Fracture of neck of femur; (c) Fall from ladder at home.

Maternal deaths: Be sure to answer the question on pregnancy and delivery. This information is neededfor all women of child-bearing age, even though the pregnancy may have had nothing to do with thedeath.

Old age or senility: Old age (or senility) should not be given as a cause of death if a more specific causeis known. If old age was a contributory factor, it should be entered in Part II. Example: (a) Chronicbronchitis, II old age.

Completeness of information: A complete case history is not wanted, but, if the information isavailable, enough details should be given to enable the underlying cause to be properly classified.

Example: Anaemia – Give type of anaemia, if known. Neoplasm – Indicate whether benign or malignant,and site, with site of primary neoplasm, whenever possible, Hear disease – Describe the conditionspecifically; if congestive heart failure, chronic on pulmonale, etc., are mentioned, give the antecedentconditions. Tetanus – Describe the antecedent injury, if known. Operation – State the condition forwhich the operation was performed. Dysentery – Specify whether bacillary, amoebic, etc., if known.Complications of pregnancy or delivery – Describe the complication specifically, Tuberculosis – Giveorgans affected.Symptomatic statement: Convulsions, diarrhea, fever, ascites, jaundice, debility, etc., are symptomswhich may be due to any one of a number of different conditions. Sometimes nothing more is known, butwhenever possible, give the disease which caused the symptom.

Manner of Death: Deaths not due to external cause should be identified as ‘Natural’. If the cause ofdeath is known, but it is not known whether it was the result of an accident, suicide or homicide and issubject to further investigation, the cause of death should invariably be filled in and the manner of deathshould be shown as ‘Pending investigation.

21

FORM NO.4A(See Rule 7)

MEDICAL CERTIFICATE OF CAUSE OF DEATH(For Non-Institutional deaths. Not to be used for stillbirths)To be sent to Registrar along with From No.2 (Death Report)

I hereby certify that the deceased Shri/Smt/Kum………………………… son of/wife of/daughterof …………………………….resident of ……………………was under my treatment from ……………to …………………. and he/she died on ………………………………at…………..A.M./P.M.

NAME OF DECEASED For use ofStatistical

OfficeSex

Age at DeathAge in completedyears

If less than 1year, age inMonths

If less than onemonth, age indays

If less than oneday, age in Hours

3. Male4. Female

CAUSE OF DEATH

I. Immediate causeState the disease, injury or complicationwhich Caused death, not the mode of dyingsuch as Heart failure, asthenia, etc.

Antecedent causeMorbid conditions, if any, giving rise to theabove Cause, stating underlying conditionslast

II.Other Significant conditions contributing to theDeath but not related to the diseases or conditionscausing it.

(a) …………………due to (or asconsequences of)

(b)………………….due to (or as

consequences of)

(c)........................

...........................

...........................

Interval betweenonset & deathApprox

……………………..

……………………..

……………………..

……………………..

……………………..

………………

………………

………………

……………..

……………..If deceased was a female, was pregnancy the deathassociated with?If yes, was there a delivery? 1. Yes 2. No

1. Yes 2. No

Name and Signature of the Medical Practitioner certifying the Cause of Death.Date of Verification:………………………………………………………………………….

SEE REVERSE FOR INSTRUCTIONS

(To be detached and handed over to the relative of the deceased)

Certified that Shri/Smt/Kum............................................... S/W/D of Shri………………………R/O……………………………… was under my treatment from…………….to…………….and he/sheexpired on ……………at ………………A.M./P.M.

Doctor:…………………………………..(Signature and address of MedicalPractitioner/Medical attendant withRegistration No.)

22

MEDICAL CERTIFICATE OF CAUSE OF DEATHDirections for completing the form

Name of deceased: To be give in full. Do not use initials. If deceased is an infant, not yet named at timeof death, write ‘Son of (S/o)’ or ‘Daughter of (D/o)’, followed by names of mother and father.Age: If the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 yearof age, give age in months and if below 1 month give age in completed number of days, and if below oneday, in hours.Cause of Deaths: This part of the form should always be completed by the attending physicianpersonally.

The certificate of cause of death is divided into two parts, I and II. Part I is again divided into three parts,lines (a) (b) (c). If a single morbid condition completely explains the deaths, then this will be written online (a) of Part I, and nothing more need be written in the rest of Part I or in Part II, for example, smallpox,lobar pneumonia, cardiac beriberi, are sufficient cause of death and usually nothing more is needed.

Often, however, a number of morbid conditions will have been present at death, and the doctor must thencomplete the certificate in the proper manner so that the correct underlying cause will be tabulated.First, enter in Part I(a) the immediate cause of death. This does not mean the mode of dying, e.g., heartfailure, respiratory failure, etc. These terms should not be appear on the certificate at all since they aremodes of dying and not causes of death. Next consider whether the immediate cause is a complication ordelayed result of some other cause. If so, enter the antecedent cause in Part I, line(b). Sometimes therewill be three stages in the course of events leading to death. If so, line (c) will be completed. Theunderlying cause to be tabulated is always written in last in Part I.

Morbid conditions or injuries may be present which were not directly related to the train of events causingdeath but which contributed in some way to the fatal outcome. Sometimes the doctor finds it difficult todecide, especially for infant deaths, which of several independent conditions was the primary cause ofdeath; but only one cause can be tabulated, so the doctor must decide. If the other diseases are noteffects of the underlying cause, they are entered in Part II.

Do not write two or more conditions on a single line. Please write the names of the diseases (in full) in thecertificates as legibly as possible to avoid the rise of their being misread.

Onset: Complete the column for interval between onset and death whenever possible, even if veryapproximately, e.g., “from birth” “several years”.

Accidental or violent deaths: Both the external cause and the nature of the injury are needed andshould be stated. The doctor or hospital should always be able to describe the injury, stating the part ofthe body injured, and should give the external cause in full when this is shown. Example: (a) Hypostaticpneumonia; (b) Fracture of neck of femur; (c) Fall from ladder at home.

Maternal deaths: Be sure to answer the question on pregnancy and delivery. This information is neededfor all women of child-bearing age, even though the pregnancy may have had nothing to do with thedeath.

Old age or senility: Old age (or senility) should not be given as a cause of death if a more specific causeis known. If old age was a contributory factor, it should be entered in Part II. Example: (a) Chronicbronchitis, II old age.

Completeness of information: A complete case history is not wanted, but, if the information isavailable, enough details should be given to enable the underlying cause to be properly classified.

Example: Anaemia – Give type of anaemia, if known. Neoplasm – Indicate whether benign or malignant,and site, with site of primary neoplasm, whenever possible, Hear disease – Describe the conditionspecifically; if congestive heart failure, chronic on pulmonale, etc., are mentioned, give the antecedentconditions. Tetanus – Describe the antecedent injury, if known. Operation – State the condition forwhich the operation was performed. Dysentery – Specify whether bacillary, amoebic, etc., if known.Complications of pregnancy or delivery – Describe the complication specifically, Tuberculosis – Giveorgans affected.Symptomatic statement: Convulsions, diarrhea, fever, ascites, jaundice, debility, etc., are symptomswhich may be due to any one of a number of different conditions. Sometimes nothing more is known, butwhenever possible, give the disease which caused the symptom.

Manner of Death: Deaths not due to external cause should be identified as ‘Natural’. If the cause ofdeath is known, but it is not known whether it was the result of an accident, suicide or homicide and issubject to further investigation, the cause of death should invariably be filled in and the manner of deathshould be shown as ‘Pending investigation.

23

Government of Tamil NadujäœehL muR

Form No.5 got« v©.5Department of ______________________________

-------------------- JiwBIRTH CERTIFICATE – Ãw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of the Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Birth which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ãw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : _______________________ Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

Date of Birth / Ãwªj nj : ____________________________

Place of Birth / Ãwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father/ jªijæ‹ Mjh® v© : ____________________________

Address of the parents at the time

of birth of the child/ Permanent address of the parents/FHªij Ãw¥Ã‹ nghJ bg‰nwhç‹ Kftç bg‰nwhç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authority

rh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu

“Ensure registration of every birth and death”“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

23

Government of Tamil NadujäœehL muR

Form No.5 got« v©.5Department of ______________________________

-------------------- JiwBIRTH CERTIFICATE – Ãw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of the Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Birth which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ãw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : _______________________ Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

Date of Birth / Ãwªj nj : ____________________________

Place of Birth / Ãwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father/ jªijæ‹ Mjh® v© : ____________________________

Address of the parents at the time

of birth of the child/ Permanent address of the parents/FHªij Ãw¥Ã‹ nghJ bg‰nwhç‹ Kftç bg‰nwhç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authority

rh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu

“Ensure registration of every birth and death”“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

23

Government of Tamil NadujäœehL muR

Form No.5 got« v©.5Department of ______________________________

-------------------- JiwBIRTH CERTIFICATE – Ãw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of the Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Birth which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ãw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : _______________________ Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

Date of Birth / Ãwªj nj : ____________________________

Place of Birth / Ãwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father/ jªijæ‹ Mjh® v© : ____________________________

Address of the parents at the time

of birth of the child/ Permanent address of the parents/FHªij Ãw¥Ã‹ nghJ bg‰nwhç‹ Kftç bg‰nwhç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authority

rh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu

“Ensure registration of every birth and death”“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

24

Government of Tamil NadujäœehL muR

Form No.6 got« v©.6Department of ______________________________

-------------------- JiwDEATH CERTIFICATE – Ïw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Death which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ïw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : ----------------------- Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

UID Number of deceased / Ïwªjtç‹ Mjh® v©: ____________________________

Date of Death / Ïwªj nj : ____________________________ Age / taJ : ________________

Place of Death / Ïwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father / jªijæ‹ Mjh® v© : ____________________________

Name of the Husband / Wife fzt® / kidéæ‹ bga® : ____________________________

UID Number of Husband / Wife / fzt® / kidéæ‹ Mjh® v© : ____________________

Address of the deceased at the time of death/ Permanent address of the deceased/Ïw¥Ã‹nghJ Ïwªjtç‹ Kftç Ïwªjtç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authorityrh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu“Ensure registration of every birth and death”

“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

24

Government of Tamil NadujäœehL muR

Form No.6 got« v©.6Department of ______________________________

-------------------- JiwDEATH CERTIFICATE – Ïw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Death which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ïw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : ----------------------- Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

UID Number of deceased / Ïwªjtç‹ Mjh® v©: ____________________________

Date of Death / Ïwªj nj : ____________________________ Age / taJ : ________________

Place of Death / Ïwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father / jªijæ‹ Mjh® v© : ____________________________

Name of the Husband / Wife fzt® / kidéæ‹ bga® : ____________________________

UID Number of Husband / Wife / fzt® / kidéæ‹ Mjh® v© : ____________________

Address of the deceased at the time of death/ Permanent address of the deceased/Ïw¥Ã‹nghJ Ïwªjtç‹ Kftç Ïwªjtç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authorityrh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu“Ensure registration of every birth and death”

“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

24

Government of Tamil NadujäœehL muR

Form No.6 got« v©.6Department of ______________________________

-------------------- JiwDEATH CERTIFICATE – Ïw¥ò rh‹¿jœ

(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 andRule 8/13 of Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original recordof Death which is the register for (local area / local body) ------------ of Taluk ------------of District -------------------------------- of State TAMIL NADU.Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------t£l« ------------- nr®ªj mrš Ïw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœtH§f¥gL»wJ.Name/ bga® : ----------------------- Sex / ghèd«: ________________

(M©/bg©/ÂUe§if)

UID Number of deceased / Ïwªjtç‹ Mjh® v©: ____________________________

Date of Death / Ïwªj nj : ____________________________ Age / taJ : ________________

Place of Death / Ïwªj Ïl« : ____________________________

Name of the Mother / jhæ‹ bga® : ____________________________

UID Number of Mother / jhæ‹ Mjh® v© : ____________________________

Name of the Father / jªijæ‹ bga® : ____________________________

UID Number of Father / jªijæ‹ Mjh® v© : ____________________________

Name of the Husband / Wife fzt® / kidéæ‹ bga® : ____________________________

UID Number of Husband / Wife / fzt® / kidéæ‹ Mjh® v© : ____________________

Address of the deceased at the time of death/ Permanent address of the deceased/Ïw¥Ã‹nghJ Ïwªjtç‹ Kftç Ïwªjtç‹ ãiyahd Kftç

------------------------------ ------------------------

------------------------------ ------------------------

Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------

Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________

Date of Issue / tH§»a ehŸ : ____________________________

Address of the Issuing Authority Signature of Issuing Authorityrh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«

Seal / K¤Âiu“Ensure registration of every birth and death”

“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

25

FORM No.7(See Rule 12)

BIRTH REGISTER

BIRTH REPORTLegal Information

This part to be added to the Birth Register

To be filled by the informant1. Date of Birth: ____________________________

(Enter the exact day, monthand year the child was born e.g.1-1-2000)

2. Sex : ___________________(Male/Female/Transgender)do not use abbreviation)

3. Name of the child, if any: ______________________(If not named, leave blank)

4. Name of the father : __________________________(Full name as usually written)UID No of Father (if any)

5. Name of the Mother: _________________________(Full name as usually written)UID No of mother (if any)

6. Address of parents at thetime of Birth of the Child ____________________________________________________________________________

7. Permanent address of parents : ________________________________________________________________________

8. Place of Birth : _____________________(Tick the appropriate entry 1 or 2 below and give the name of the Hospital/Institution or theaddress of the house where the birth took place)

5. Hospital / Institution Name & ___________________Address ________________________________________

6. House Address: ________________________________

7. Others ________________________________

9. Informant’s name: ________________________________Address: ________________________________

(After completing all columns 1 to 22, informant will put date and signature here:)

Date: Signature or left thumb mark of the informantTo be filled by the Registrar

Registration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

26

FORM No.8(See Rule 12)

DEATH REGISTERDEATH REPORTLegal Information

This part to be added to the Birth Register

To be filled by the informant1. Date of Death: ___________________________

(Enter the exact day, monthand year the death took place) (e.g.1.1.2000)

2. Name of the Deceased: _______________________(Full name as usually written)UID No of deceased (if any)

3. Sex of the deceased: _________________________Male/Female/Transgender (do not use abbreviation)

4. Name of the Mother: _______________________________UID No of mother (if any)

5. Name of the Father: _________________________________UID No of Father (if any)

5.a. Name of Husband/Wife: ______________________________UID No of Husband/Wife (if any)

6. Age of the deceased: __________________________________(If the deceased was over 1 year of age, give age in completed years. If the deceased was below1 year of age, give age in months, and if below 1 month give age in completed number of days,and if below one day, in hours)7. Address of the deceased at the time of death:_____________

________________________________________________________8. Permanent address of the deceased: _____________________

________________________________________________________9. Place of death: ________________________

(Tick the appropriate entry 1,2, or 3 below and give the name of the Hospital / Institution orthe address of the house where the death took place. If other place, give location)

8. Hospital / Institution Name:___________________& Address : ___________________________________

9. House Address: ______________________________10. Other place __________________________________

10. Informant’s name: _____________________________________Address: _______________________________________________(After completing all columns 1 to 21, informant will put date and signature here:)

Date: Signature or left thumb mark of the informant

To be filled by the RegistrarRegistration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

27

FORM No.9(See Rule 12)

STILL BIRTH REGISTERSTILL BIRTH REPORT

Legal InformationThis part to be added to the Birth Register

To be filled by the informant1. Date of Birth: ________________________________

(Enter the exact day, monthand year) (e.g.01-01-2000)

2. Sex : ____________________Male/Female/Transgender)do not use abbreviation)

3. Name of the father : ________________________(Full name as usually written)UID No of father (if any)

4. Name of the mother: __________________________(Full name as usually written)UID No of Mother (if any)

5. Place of Birth : (Tick the appropriate entry below and give the name of theHospital/Institution or the address of the house where the birth took place)

1. Hospital / Institution Name & ___________________Address: ______________________________________

2. House Address: _______________________________

5.a. Permanent address of parents : __________________

__________________________________________________5.b. Address of parents at the

time of Still Birth of the Child _______________________________________________________________________

6. Informant’s name: _______________________________Address: ________________________________________

(After completing all columns 1 to 12, informant will put date and signature here:)

Date: Signature or left thumb mark of the informantTo be filled by the Registrar

Registration No: Registration Date:Registration Unit: District:Town/Village:Remarks: (If any)

Name and Signature of the Registrar

28

Form No.10(See Rule 13)

NON-AVAILABILITY CERTIFICATE

(Issued under section 17 of the Registration of Births and Deaths Act, 1969)

This is to certify that a search has been made on the request of Shri/Smt./Kum ………

………………………………………………………………………………………….. son / wife / daughter of

………………………………………………………………………. in the registration records for the

years(s) …………………………………….. relating to (local area) ……………………………………….. of

(Tahsil) ………………………………………. of (District)……………. of (State) and found that the

event relating to the Birth/Death of ……………………………………………….. son / daughter of

…………………………………… was not registered.

Signature of Registrar

Date: ………………………………….. Signature of issuing authority

Date

Seal

29

Form No. 11

(See Rule 14)

SUMMARY MONTHLY REPORT OF BIRTHS

1. Report for the Month of: ………………………………………………. Year…………………

2. District:……………………………………………………………………………………………….

3. Town/ Village:………………………………………………………………………………………

4. Registration Unit:……………………………………………………………………………………

5. Number of Births Registered:……………………………………………………………………..

(a) Within one year of their Occurrence:

(b) After one year of their Occurrence:

Total*(a+b):

*Total should be equal to the number of statistical part of Birth Report Forms (Form No.1)attached with this monthly report.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar / Additional District Registrar

30

Form No. 12(See Rule 14)

SUMMARY MONTHLY REPORT OF DEATHS

1. Report for the Month of: ………………………………………………. Year…………………

2. District:……………………………………………………………………………………………….

3. Town/ Village:………………………………………………………………………………………

4. Registration Unit:……………………………………………………………………………………

5. Details of Deaths Registered during the Month:……………………………………………..

Deaths InfantDeaths

MaternalDeathsRegistered within one year of

occurrenceRegistered after one year ofoccurrence

Total*

1. 2. 3. 4. 5.

Note: Infant and Maternal Deaths should also be included in the Deaths.

*Total should be equal to the number of statistical part of Death Report Forms (Form No.2)attached with this monthly report.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar /Additional District Registrar

31

Form No. 13

(See Rule 14)

SUMMARY MONTHLY REPORT OF STILL BIRTHS

1. Report for the Month of: ………………………………………………. Year…………………

2. District:……………………………………………………………………………………………….

3. Town/ Village:………………………………………………………………………………………

4. Registration Unit:……………………………………………………………………………………

5. Number of Births Registered:……………………………………………………………………..

*Number of still births registered should be equal to the number of Still Birth report forms(Form No.3) attached with this monthly report.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar / Additional District Registrar

32

Form No.14-A[See Under Rule (12)]

[Under Rule 12(4) Under Sec 16]CONTROL REGISTER FOR THE YEAR………………………….

(PART A)Name of Taluk/Panchayat Union:

Nam

e of

Panc

haya

ts/V

illag

e/To

wn

January February March April May June July August September October November December

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

e of

Des

patc

h

Dat

e of

Rec

eipt

Dat

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Des

patc

h

Dat

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eipt

Dat

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Dat

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eipt

Dat

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Des

patc

h

Dat

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Rec

eipt

Dat

e of

Des

patc

h

33

Form No.14-B[See Rule 4 and 15]

FORM NO.14 - B AS IN THE EXISTING RULES(PART B)

Name of Taluk/Panchayat Union:

Nam

e of

Panc

haya

ts/V

illag

e/To

wn

January February March April May June July August September October November December

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

Dea

th

Bir

th

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th

Bir

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Bir

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