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State of Madhya Pradesh - Act

The M.P. Registration of Births and Death Rules, 1999

MADHYA PRADESH
India

The M.P. Registration of Births and Death Rules, 1999

Rule THE-M-P-REGISTRATION-OF-BIRTHS-AND-DEATH-RULES-1999 of 1999

Published on 2 March 2000
Commenced on 2 March 2000
[This is the version of this document from 2 March 2000.]
[Note: The original publication document is not available and this content could not be verified.]

The M.P. Registration of Births and Death Rules, 1999Published vide Notification No. 307-3757-99-23-E.S., dated 2-3-2000, M.P. Rajpatra, Part 4(Ga), dated 17-3-2000 at pages 74-05In exercise of the powers conferred by Section 30 of the Registration of Birth and Deaths Act, 1969 (No. 18 of 1969) the State Government with the prior approval of the Central Government, hereby makes the following rules, namely :-

1. Short title and commencement.

(1)These rules may called the Madhya Pradesh Registration of Births and Deaths Rules, 1999.

(2)They shall come into force with effect from 1-1-2000.

2. Definitions.

- In these rules, unless the context otherwise requires :-

(a)"Act" means the Registration of Births and Deaths Act, 1969 (No. 18 of 1969);

(b)"Form" means a Form appended to these rules; and

(c)"Section" means a Section of the Act.

3. Period of gestation.

- The period of gestation for the purpose of clause (g) of sub-section (1) of Section 2 shall be twenty-eight weeks.

4. Submission of report under Section 4 (4).

- The report under sub-section (4) of Section 4 shall be prepared in the prescribed format appended to these Rules and shall be submitted along with the statistical report referred to in sub-section (2) of Section 19, to the State Government by the Chief Registrar for every year by the 31st July of the year following the year to which the report relates.

5. Form, etc. for giving information of births and deaths.

(1)The information required to be given to the Registrar under Section 8 or Section 9. as the case may be, shall be in Form Nos. 1, 2 and 3 for the Registration of a birth, death and still birth respectively, hereinafter to be collectively called the reporting forms. Information if given only orally, shall be entered by the Registrar in the appropriate reporting forms and the signature/thumb impression of the informant obtained.

(2)The part of the reporting form containing legal information shall be called the 'Legal Part' and the part containing statistical information shall be called the 'Statistical Part'.

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

6. Birth or death in a vehicle.

(1)In respect of a birth or death in a moving vehicle, the person incharge of the vehicle shall give or cause to be given the information under sub-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 kind used on land, air or water and includes an aircraft, a boat, a ship, a railway carriage, a motor-car, a motor-cycle, a cart, a tonga and a rickshaw.

(2)In 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 be given the information under sub-section (1) of Section 8.

7. Form of certificate under Section 10 (3).

- The certificate as to the cause of death required under sub-section (3), of Section 10 shall be issued in Forms Nos. 4 and 4-A and the Registrar shall, after making necessary entries in the register of deaths, forward all such certificates to the Chief Registrar or the officer specified by him in this behalf by the 10th of the month immediately following the month to which the certificates relate.

8. Extracts of registration entries to be given by Section 12.

(1)The extracts of particulars from the register relating to births or deaths to be given to an informant under Section 12 shall be in Form No. 5 or Form No. 6, as the case may be.

(2)In the case of domicilliary events of births and deaths referred to in clause (a) of sub-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 relative of the head present in house may collect the extracts of birth or death from the Registrar within thirty days of its reporting.

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

(4)In the case of institutional events of births and deaths referred to in clauses (b) to (e) of sub-section (1) of Section 8, the nearest relative of the new born or deceased may collect the extract from the officer or person in charge of the institution concerned within thirty days of the 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 in sub-rules (2) to (4) within the period stipulated therein, the Registrar or the officer or person incharge of the concerned institution as referred to in sub-rule (4) shall transmit the same to the concerned family by post within fifteen days of the expiry of the aforesaid period.

9. Authority for delayed registration and fee payable therefore.

(1)Any birth or death of which information is given to the Registrar after the expiry of the period specified in Rule 5, but within thirty days of its occurrence, shall be registered on payment of a late fee of rupees two.

(2)Any birth or death of which information is given to the Registrar after thirty days but within one year of its occurrence, shall be registered only with the written permission of the officer authorised in this behalf and on payment of a late fee of rupees five and on the production of an affidavit made before a Notary or any other officer authorised in this behalf by the State Government.

(3)Any birth or death which has not been registered within one year of its occurrence, shall be registered only on an order of a Magistrate of the first class or an Executive Magistrate and on payment of a late fee of rupees ten.

10. Period for the purpose of Section 14.

(1)Where the birth of any child had been registered without a name, the parent or guardian of such child shall, within 12 months from the date of registration of the birth of child, give information regarding the name of the child to the Registrar either orally or in writing :Provided that if the information is given after the aforesaid period of 12 months but within a period of 15 years, which shall be reckoned-

(i)In case where the registration had been made prior to the date of commencement of the Registration of Births and Deaths (Amendment) Rules, 1986 from such date, or

(ii)In case where the registration is made after the date of commencement of the Registration of Births and Deaths (Amendment) Rules, 1986 from the date of such registration, subject to the provisions of sub-section (4) of Section 23, Registrar shall-

(a)if the register is in his possession forthwith enter the name in the relevant column of the concerned form in the birth register on payment of a late fee of rupees five,

(b)if the register is not in his possession and if the information is given orally, make a report giving necessary particulars, and, if the information is given in writing, forward the same to the officer authorised by the State Government in this behalf for making the necessary entry on payment of a late fee of rupees five.

(2)The parent or the guardian, as the case may be, shall also present to the Registrar the copy of the extract given to him under Section 12 or a certified extract issued to him under Section 17 and on such presentation the Registrar shall make the necessary endorsement relating to the name of the child or lake action as laid down in clause (b) of the proviso to sub-rule (1).

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

(1)If it is reported to the Registrar that a clerical or formal error has been made in the register or if such error is otherwise noticed by him and if the register is in his possession, the Registrar 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 cancelling the entry) as provided in Section 15 and shall send an extract of the entry showing the error and how it has been corrected to the State Government or the officer specified by it in this behalf.

(2)In the case referred to in sub-rule (1) if the register is not is his possession, the Registrar shall make a report to the State Government or the officer authorised by it in this behalf and call for the relevant register and after enquiring into the matter, if he is satisfied that any such error has been made, make the necessary correction.

(3)Any such correction as mentioned in sub-rule (2) shall be counter-signed by the State Government or the officer authorised by it in this behalf when the register received from the Registrar.

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

(5)Notwithstanding anything contained in sub-rule (1) and sub-rule (4) the Registrar shall make report if any correction of the kind referred to therein giving necessary details to the State Government or the officer authorised in this behalf.

(6)If it is proved to the satisfaction of the Registrar that any entry in the register of births and deaths has been fraudulently or improperly made, he shall make a report giving necessary details to the officer authorised by the Chief Registrar by general or special order in this behalf 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 thereof should be sent to the permanent address of the person who has given information under Section 8 or Section 9.

12. Form of register under Section 16.

- The legal part of the Form Nos. 1, 2 and 3 shall constitute the birth register, death register and still birth register (Form Nos. 7, 8 and 9) respectively.

13. Fees and postal charges payable under Section 17.

(1)The fees payable for a search to be made, an extract or a non-availability certificate to be issued under Section 17, shall be as follows :-

		Rs.
(a)	Search for a single entry in the first year for which thesearch is made	2.00
(b)	for every additional year for which the search is continued	2.00
(c)	for granting extract relating to each birth or death	5.00
(d)	for granting non-availability certificate of birth or death	2.00

(2)Any such extract in regard to a birth or death shall be issued by the Registrar or the Officer authorised by the State Government in this behalf in Form No. 5 or as the case may be, in Form No. 6 and shall be certified in the manner provided for in Section 76 of the Indian Evidence Act, 1872 (No. 1 of 1872).

(3)If any particular event of birth and death is not found registered the Registrar shall issue a non-availability certificate in Form No. 10.

(4)Any such extract or non-availability certificate may be furnished to the person asking for it or sent to him by post on payment of the postal charges therefor.

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

(1)Every Registrar shall after completing the process of registration send all the Statistical parts of the reporting forms relating to each month alongwith a Summary Monthly Report in Form No. 11 for births. Form No. 12 for deaths and Form No. 13 for still births to the Chief Registrar or the officer authorised by him on or before the 5th of the following month.

(2)The officer so authorised shall forward all such statistical parts of the reporting forms received by him to the Chief Registrar not later than the 10th of the month.

15. Statistical report under Section 19 (2).

- The statistical report under sub-section (2) of Section 19 shall contain the tables in the prescribed formats appended to these rules and shall be compiled for each year before the 31st July of the year immediately following and shall be published as soon as may be thereafter but in any case not later than five months from that date.

16. Conditions for compounding offences.

(1)Any offence punishable under Section 23 may, cither before or after institution of criminal proceedings under the Act, be compounded by an officer authorised by the Chief Registrar by a general or special order in this behalf, if the officer so authorised is satisfied that the offence was committed through inadvertence or oversight for the first time.

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

17. Registers and other records under Section 30 (2) (k).

(1)The birth register, death register and still birth register shall be records of permanent importance and shall not be destroyed.

(2)The Court orders and orders of the authorised officers granting permission for delayed registration received 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) of Section 10 shall be retained for a period of an least 5 years by the Chief Registrar or the officer authorised by him in this behalf.

(4)Every birth register, death register and still birth register shall be retained by the Registrar in his office for a period of twelve months after the end of the calendar year to which it relates and such register shall thereafter be transferred for safe custody to such officer as may be authorised by the State Government in this behalf.

18. Repeal and saving.

- The Madhya Pradesh Registration of Births and Deaths Rules, 1973 is hereby repealed :Provided that any order made or action taken under the rules so repealed shall be deemed to have been made or taken under the corresponding provisions of these rules.Format of the Report on the Working of the Act(See Rule 4)

1. Brief description of the 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 birth 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 Instructions issued under the Act.

15. General remarks.

Birth Report Form(See Rule 5)Form No. 1Birth Report Form(Legal Information)(To be filled by the informant)

1. Date of Birth..................................................................

2. Sex : Male/Female..............................................................

3. Name of the child, if any........................................................

(if not named, leave blank)

4. Name of the father....................................and address........................................

5. Name of the mother..................................

6. Place of birth (√ the appropriate entry below)

(1)Hospital/Institution :Name.......................................

(2)House..........................................Address....................................

7. Informant's name and address

..................................................................................................................................................................................................................................................................................................Date :....................................Signature/thumb mark of the informant(To be filled by the Registrar)Registration No........................Registration date....................Registration Unit........................................................................Town/Village...............................................................................District.........................................................................................Remarks......................................................................................Name and Signature of the Registrar and SealBirth Report(Statistical information)(To be filled by the informant)

8. Town or Village of Residence of the mother :

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

(1)Town (2) Village

(c)Name of District........................................................

(d)Name of State...........................................................

9. Religion of the Family

(√ the appropriate entry below)

(1)Hindu (2) Muslim (3) Christian

(4)Any other religion.......................................(mention name)

10. Father's level of education....................................................

(Enter the completed level of education)

11. Mother's level of education....................................................

(Enter the completed level of education)

12. Father's occupation............................................................

13. Mother's occupation............................................................

14. Age of the Mother at the time of marriage......................................(in completed years)

15. Age of the mother at the time of this birth..................................

16. Number of children born alive to the mother so far including this child

17. Type of attention at delivery :

(√ the appropriate entry below)

(1)Institutional-Government

(2)Institutional-Private or Non-Government

(3)Doctor, Nurse or Trained midwife

(4)Traditional Birth Attendant

(5)Relatives or others

18. Method of Delivery :

(√ the appropriate entry below)

(1)Natural (2) Cesarean (3) Forceps/Vacuum

19. Birth weight (in kgs.) (if available).......................................

20. Duration of pregnancy (in weeks)............................................

(To be filled by the Registrar)

Name	Code No.
District................................	................................................
Tehsil..................................	................................................
Town Village.......................	................................................
Registration Unit..................	................................................
Registration No....................	Registration date...................
Date of birth......................

Sex : (1) Male (2) FemalePlace of birth : (1) Hospital/Institution (2) HouseName and Signature of theRegistrar and SealDeath Report Form(See Rule 5)Form No. 2Death Report Form(Legal information)(To be filled by the informant)

1. Date of Death..................................................................................

2. Name of the deceased.......................................and full address.......................................

3. Sex of the deceased : Male/Female

4. 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 if below 1 month give age in completed number of days and if below one day, in hours)

4. (a) Name of father/husband of the deceased.................................

5. Place of death (√ the appropriate entry below)

(1)Hospital/Institution :Name...............................................................

(2)House..............................................................Address............................................................

(3)Other place...........................................................

6. Informant's name & Address....................................................

Date :.................Signature/thumb mark of the informant(To be filled by the Registrar)Registration No................................................ Registration date................................................Registration Unit.............................................................................................................................Town/Village....................................................................................................................................District..............................................................................................................................................Remarks...........................................................................................................................................Name and Signature of theRegistrar and SealDeath Report(Statistical Information)(To be filled by the informant)

7. Town or village of Residence of the deceased :

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

(1)Town (2) Village

8. Religion of the family :

(√ the appropriate entry' below)

(1)Hindu (2) Muslim (3) Christian

(4)Any other religion (mention name)

9. Occupation of the deceased................................

10. Type of medical attention received before death :

(√ the appropriate entry below)

(1)Institutional

(2)Medical attention other than institution

(3)No medical attention

11. Was the cause of death medically certified...............

(√ the appropriate entry below)

(1)Yes (2) No

12. Name of Disease or Actual Cause of Death :

(whether medically Certified or not)

13. In case this is a female death, did the death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy :

(√ the appropriate entry below)

(1)Yes (2) No

14. If used to habitually smoke................................

For how many years ?

15. If used to habitually chew tobacco in any form :

For how many years ?

16. If used to habitually chew areanut in any form :

(including pan masala)-For how many years ?

17. If used to habitually drink alcohol :

For how many years ?(To be filled by the Registrar)

Name	Code No.
District................................	................................................
Tehsil..................................	................................................
Town Village.......................	Registration Unit..................
Registration No....................	Registration date...................
Date of birth..................................................................

Sex : (1) Male, (2) FemaleAge- (Years/Months/Days/Hours)Place of death :

(1)Hospital/Institution (2) House (3) OtherName and Signature of theRegistrar and SealStill Birth Report Form(See Rule 5)Form No. 3Still Birth Report Form(Legal information)(To be filled by the informant)

1. Date of Birth : .............................................

2. Sex : Male/Female : ...................................

3. Name of the father : ....................................and address : ..................................................

4. Name of the mother : ..................................

5. Place of birth (the appropriate entry below)

(1)Hospital/Institution : .......................Name: .......................................

(2)House Address : ..............................

6. Informant's name : ....................................

Address : ........................................Date :Signature/thumb marks of the informant(To be filled by the Registrar)Registration No. : ............Registration date..........Registration Unit: ...................................................Town/Village : .........................................................District: ....................................................................Remarks (if any) : ...................................................Name and Signature of the Registrarand Seal(Statistical information)(To be filled by the informant)

7. Town or Village of Residence of the mother :

(a)Name of Town/Village : .........................................

(b)Is it a town or village (V the appropriate entry below)

1. Town 2. Village

(c)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)

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

1. Institutional-Government

2. Institutional-Private or Non-Government

3. Doctor, Nurse or Trained midwife

4. Traditional Birth attendant

5. Relatives or others.

11. Duration of pregnancy : (in weeks)

12. Cause of foetal death : (if known)

(To be filled by the Registrar)

Name	Code No.
District................................	................................................
Tehsil..................................	................................................
Town Village.......................	................................................
Registration Unit..................	................................................
Registration No....................	Registration date :...................
Date of birth......................

Sex: 1. Male 2. FemalePlace of Birth : 1. Hospital/Institution 2. HouseName and Signature ofthe Registrar and SealForm No. 4(See Rule 7)Medical Certificate of Cause of Death(Hospital In-patients. Not to be used for still births)To be sent to Registrar alongwith Form No. 2 (Death Report)Name of the Hospital...................................................................I hereby certify that the person whose particulars are given below died in the hospital in Ward No......................on............... at................a.m./p.m.

Name of Deceased	For use of Statistical Office
Sex	Age at Death
Age in completed years	If less than 1 year, age in months	If less than one month, age in Days	If less than one day, age in Hours
1. Male2. Female

Cause of DeathInterval between on set anddeath approx.

I. Immediate cause	(a) ..................
State the disease, injury orcomplication which causeddeath,not the mode of dying such as heartfailure,asthenia, etc.	due to (or asa consequences of)
Antecedent cause	(b)..................
Morbid conditions, if any, givingrise to the above causestatingunderlying conditions last	due to (or asa consequences of)
II. Other significant conditionscontributing to the deathbut notrelated to the disease or conditionscausing it	(c)..................how did theinjury occur?

Manner of Death

1. Natural 2. Accident 3. Suicide

4. Homicide 5. Pending investigation

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

	Name and signature of the Medical Attendant certifying thecause of death
	Date of verification.............................

See Reverse For Instructions

Name of Deceased	For use of Statistical Office
	Age at Death
Sex	Age in completed years If less than If less than If less 1year, age one month, than one in months age in Days day, age inHours
1. Male2. Female

Cause Of DeathInterval between on set anddeath approx.

I. Immediate cause	(a) ..................
State the disease, injury orcomplication which causeddeath,not the mode of dying such as heartfailure,asthenia, etc.	due to (or asa consequences of)
Antecedent cause	(b)..................
Morbid conditions, if any, givingrise to the above causestatingunderlying conditions last	due to (or asa consequences of)
II. Other significant conditionscontributing to the deathbut notrelated to the disease or conditionscausing it	(c)..................

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

	Name and signature of the Medical Attendant certifying thecause 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./Ku..........................................S/W/D/ of Shri.................................... R/O............................... was under my treatment from................to............and he/she expired on............at................a.m./p.m.Doctor............................Signature and address of MedicalPractitioner/Medical attendant with Registration No.Form No. 5(See Rule 8)Birth Certificate(Issued under Section 12/17)This is to certify that the following information has been taken from the original record of birth which is the register for (Local Area)...................of Tehsil..................of District................of State.............Name....................................................................Sex.......................................................................Date of Birth.........................................................Place of Birth........................................................Name of Lather....................................................Name of Mother...................................................Registration No...................................................Date of Registration............................................Date................Signature of Issuing AuthoritySealForm No. 6(See Rule 8)Birth Certificate(Issued under Section 12/17)This is to certify that the following information has been taken from the original record of death which is the register for (Local Area)........................of Tehsil.......................of District of State.Name....................................................................Father's Name.....................................................Sex.......................................................................Date of Birth.........................................................Registration No...................................................Date of Registration............................................Date................Signature of Issuing AuthoritySealNo disclosure shall be made of particulars regarding the cause of death as entered in the Register. See proviso to Section 17 (1).Form No. 7(See Rule 12)Birth RegisterForm No. 1 : Birth Report(Legal information)(To be filled by the informant)

1. Date of Birth: .....................................

2. Sex : Male/Female : ............................

3. Name of the Child, if an............................

(If not named, leave blank)

4. Name of the father: ............................ and address : .................................

5. Name of the mother : ...........................

6. Place of birth (√ the appropriate entry below)

(1)Hospital/Institution :Name: ....................................

(2)House :....................................Address : ................................

7. Informant's name and address :................................................................................................

Date :...........................Signature/thumb mark of the informant(To be filled by the Registrar)Registration No. : ..............Registration............date........Registration Unit : .....................................Town/Village : ..........................................District : ..............................................Remarks : ...............................................Name and Signature of the Registrarand SealForm No. 8(See Rule 12)Death RegisterForm No. 2 : Death Report(Legal information)(To be filled by the informant)

1. Date of Death : ..................................................

2. Name of the Deceased : ...........................................

and full address : ...........................................

3. Sex of the deceased : Male/Female : ..............................

4. Age of the deceased : ............................................

(a)Name of Father/Husband of the deceased :

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

5. Place of Death (the appropriate entry below)

(1)Hospital/Institution :Name: ......................................

(2)House Address : ................................................

(3)Other Place : ..................................................

6. Informant's name :.......................................................

Address : .........................................................................Date :...................................Signature/thumb mark of the informant(To be filled by the Registrar)Registration No. : ..............Registration............date........Registration Unit : .....................................Town/Village : ..........................................District : ..............................................Remarks : ...............................................Name and Signature of the Registrarand SealForm No. 9(See Rule 12)Still Birth RegisterForm No. 3 : Still Birth Report(Legal information)(To be filled by the informant)

1. Date of Birth: ....................................

2. Sex : Male/Female : ...........................

3. Name of the father : ..........................and address : ................................

4. Name of the mother : ..........................

5. Place of birth (√ the appropriate entry below)

(1)Hospital/Institution :Name: ...................................

(2)House :...................................Address : ...............................

6. Informant's name : ..................................................

Address : ......................................................Date :................................Signature/thumb mark of the informant(To be filled by the Registrar)Registration No. : ..............Registration............date........Registration Unit : .....................................Town/Village : ..........................................District : ..............................................Remarks : ...............................................Name and Signature of the Registrar and SealForm 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 year(s) relating to (Local area)...........................................of (Tehsil)................of (District)..................of (State)..........................................and found that the event relating to the birth/death of........................................................son/daughter of......................was not registered.Date..............................Signature of Issuing AuthoritySealForm 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 Occurrence....................................

(b)After one year of their Occurrence...............................

Total* (a + b) :Date :...................Signature and Name of the RegistrarSubmitted to the Chief Registrar/District Registrar.* Total should be equal to the number of statistical part of Birth Reporting Forms (Form No. 1) attached with this monthly report.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. Number of Deaths Registered during the Month :

Deaths	Infants Deaths	Maternal deaths
Registered within one year of occurrence	Registered after one year of occurrence	Total*
(1)	(2)	(3)	(4)	(5)

Note :- Infant and Maternal Deaths should also be included in the Deaths.Dated :........................Signature and Name of the RegistrarSubmitted to the Chief Registrar/District Registrar.* Total should be equal to the number of statistical part of Death Reporting Forms (Form No. 2) attached with this another report.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 Still Births Registered* :.................................................................

*Number of Still Births Registered should be equal to the number of Still Report Forms (Form No. 3) attached with this monthly report.Dated :................................Signature and Name of the Registrar* Submitted to the Chief Registrar/District Registrar.

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State of Madhya Pradesh - Act