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State of Andhra Pradesh - Section
Section 19 in Andhra Pradesh Registration of Births and Deaths Rules, 1999
19. Birth Weight (in kgs.) (if
available):20. Duration of pregnancy (in weeks):(Columns to be filled are over. Now put signature at left)|}| To be filled by the Registrar | To be filled by Registrar | ||||
| Registration No.: | Registration Date: | Name : | Code No.: | Registration No. | Registration Date : |
| Registration Unit:Town/Village:District:Remarks: (if any).Name and Signature of the Registrar | District:Tahsil:Town/Village:Registration Unit: | Date of Birth :Sex : 1. Male 2. FemalePlace of Birth: 1Hospital/Institution 2. HouseName and Signature of the Registrar. |
| DeathReportLegal InformationThis Part to beadded to the Death Registrar | Form No. 2(SeeRule 5)Death Report FormStatisticalInformationThispart to be detached and sent for statistical processing | |
| To be filled bythe informant1. Date of Death: (Enter theexact day, month and year the death took place e.g. 1-1-2000).2. Name of the Deceased:(Fullname as usually written)3. Sex of the deceased:(Enter"male" or "female", do not use abbreviation)4. Age of the deceased:(ifthe 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, andif below 1 month give age in completed number of days, and ifbelow one day, in hours)5. Place of Death:(Tick theappropriate entry 1, 2 or 3 below and give the name of theHospital/Institution or the address of the house where the deathtook place. If other place, give location)1.Hospital/InstitutionName:2.House Address:3.Other Place6. Informant'sname:Address:(After completing all columns 1 to 17,informant will put date and signature here:){| | ||
| Date: | Signature or left thumb mark of the informant |