State of Andhra Pradesh - Act
Andhra Pradesh Registration of Births and Deaths Rules, 1999
ANDHRA PRADESH
India
India
Andhra Pradesh Registration of Births and Deaths Rules, 1999
Rule ANDHRA-PRADESH-REGISTRATION-OF-BIRTHS-AND-DEATHS-RULES-1999 of 1999
- Published on 29 December 1999
- Commenced on 29 December 1999
- [This is the version of this document from 29 December 1999.]
- [Note: The original publication document is not available and this content could not be verified.]
1. Short title:
2. Definitions:
- In these rules, unless the context otherwise requires: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. (a) 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.(b)Registrar's office arrangements during his absence:- (1) The office of the Registrar may be in his place of residence or business or such other place as may be designated by him.5. Form, etc. for giving information of births and deaths under Sections 8 & 9:
6. Birth or Death in a Vehicle:
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 Form No. 4 or 4A in respect of Institutional and non-Institutional deaths respectively 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. Extract of registration entries to be given under Section 12:
9. Authority for delayed registration and fee payable therefor under Section 13:
10. Period for the purpose of Section 14:
11. Correction or cancellation of entry in the register of births and deaths:
12. Form of register under Section 16:
- The legal part of the Forms No. 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:
| Rupees | ||
| (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 |
| (a) | In a Municipality or Municipal Corporation or cantonment orProject Township or Industrial Township. | To the Municipality or Municipal Corporation or Cantonment orProject Township or Industrial Township funds respectively. |
| (b) | In a Gram Panchayat Constituted under the A.P. Gram PanchayatAct, 1964 where the Executive Authority gives and certifiesextract under Section 17 of the Act. | To the Gram Panchayat Funds. |
| (c) | In other areas | To State Govt., Funds (i.e.) to the Head of Account "065- other Administrative Services—C. Other services –M.H.55 - Other receipt S.H.(02) Registrar General of Births,Deaths and Marriages. |
14. Interval and forms of periodical returns under Section 19(1):
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 complied 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:
17. Registers and other records under Section 30(2)(K):
| Local Area | Designation of officers responsible for safe custody of allbirth and death registers and relevant documents. |
| a. Any Municipality/MunicipalCorporation/Cantonment/Industrial project township/Panchayat | The concerned Registrar of births and deaths |
| b. Any other area | The M.R.O. having jurisdiction over the area |
18. Inspection of registers and other records under Section 18:
- The Inspecting Officers shall use Form No. 14 for inspection of registration centres.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 level;
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.
14. Orders and instructions issued under the Act.
15. General remarks.
| BirthReportLegal InformationThis part to be added to the Birth Register | Form No. I(See Rule 5)BirthReport FormStatistical InformationThis part to bedetached and sent for statistical processing | In the case of multiple births fill in a separate from foreach child and write “Twin birth” or Triple Birth”etc. as the case may be, in the remarks column in the box belowleft. |
| To be filled bythe informant1. Date of Birth:-(Enter the exact day, month and year the child was born e.g.1-1-2000).2. Sex: (Enter "maleor "female"; do not use abbreviation).3. Name of the child,if any:(If not named, leave blank).4. Name of thefather:(Full name as usually written).5. Name of themother:(Full name as usually written).6. Place ofbirth:(Tick the appropriate entry 1 or 2 below and give thename of the Hospital/Institution or the address of the housewhere the birth took place).1. Hospital/Institution Name:2.House Address7. Informant'sname:Address:(After completingall columns 1 to 20, informant will put date and signaturehere:).{| | ||
| Date | Signature or left thumb mark of the informant |
8. Town or Village of
Residence of the mother:(Place where the mother usuallylives. 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:(Tickthe appropriate entry below).1. Town 2. Village(c) Nameof District:(d) Name of State:9. Religion of the
Family:(Tick the appropriate entry below).1. Hindu 2.Muslim 3. Christian4. Any other religion: (Write name of thereligion).10. 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).11. 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).12. Father's
occupation:(If no occupation write 'Nil).13. Mother's
occupation:(If no occupation write 'Nil).| To be filled bythe informant14. Age of the mother (in
completed years) at the time of Marriage:(If married morethan once, age at first marriage may be entered).15. Age of the mother (in
completed years) at the time of this birth:16. Number of children born alive
to the mother so far including this child:(Number of childrenborn alive to include also those from earlier marriage(s), ifany).17. Type of attention
at delivery:(Tick the appropriate entry below).1.Institutional – Government2. Institutional - Private orNon Government3. Doctor, Nurse or Trained midwife4.Traditional Birth Attendant5. Relatives or others18. Method of Delivery:(Tick
the appropriate entry below).1. Natural2. Cesarean3.Forceps/Vacuum19. 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 |
7. Town or Village of Residence
of the deceased:(Place where the deceased actually lived.This can be different from the place where the death occurred.The house address is not required to be entered.)(a) Name ofTown/Village:(b) Is it a Town or Village:(Tick theappropriate entry below.)1. Town 2. Village(c) Name ofDistrict:(d) Name of State:8. Religion:(Tick the
appropriate entry below.)1. Hindu 2. Muslim 3. Christian4.Any other religion:(Write the name of the religion.)9. Occupation of the
deceased:(If no occupation write 'Nil')10. Type of medical attention
received before death:(Tick the appropriate entry below.)1.Institutional2. Medical attention other than Institution3.No medical attention| To be filled bythe informant11. Was the cause of death
medically certified?:(Tick the appropriate entry below)1.Yes 2. No12. Name of Disease or Actual
Cause of Death:(For all deaths irrespective of whethermedically certified or not.)13. In case this is a female
death, did the death occur while pregnant, at the time ofdelivery or within 6 weeks after the end of pregnancy:(Tickthe appropriate entry below)1. Yes 2. No14. 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
arecanut in any form (including pan masala) - for how manyyears?:17. If used to habitually drink
alcohol - for how many years?:(Columns tobe 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 Death :Sex : 1. Male 2. FemaleAge: Years/months/days/hoursPlace of Death: 1Hospital/Institution 2. House 3. Other PlaceName and Signature of the Registrar. |
| Still BirthReportLegal InformationThispart to be added to the Still Birth Registrar | Form No.3(SeeRule 5)Still Birth ReportStatistical ReportThis part to be detached and sent forstatistical processing | In the case of multiple births, fill in a separate form foreach child and write 'Twin Birth' or 'Triple Birth' etc. as thecase may be in the box below left. |
| To be Filled bythe informant1. Date of Birth:(Enter theexact day, month and year e.g.1-1-2000)2. Sex: (Enter "male"or "female")(Do not use abbreviation)3. Name of the father:(Fullname as usually written).4. Name of the mother:(Fullname as usually written).5. Place ofbirth:(Tick the appropriate entry below and give the name ofthe Hospital/Institution or the address of the House where thebirth took place).1. Hospital/Institution Name:2. HouseAddress:6. Informant's name:Address:(After completing all columns 1to 12, informant, will put date and signature here:){| | ||
| Date: | Signature or left thumb mark of the informant |
7. Town or Village of
Residence of the mother:(Place where the mother usuallylives. 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:(Tickthe appropriate entry below).1. Town 2. Village(c) Nameof 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. ifstudied upto class VII but passed only class VI, write class VI).10. Type of attention at
delivery:(Tick the appropriate entry below).1.Institutional – Government2. Institutional - Private orNon Government3. Doctor, Nurse or Trained midwife4.Traditional Birth Attendant5. Relatives or others11. Duration of pregnancy: (in
weeks)12. Cause of foetal death: (if known)(Columns to be filledare 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/Institution2. HouseName and Signature of the Registrar. |
| Name of Deceased | For use of Statistical Office | ||
| Sex | Age at Death | ||
| If 1 year or more, age in 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. FemaleCauseof DeathI.Immediate cause{| | |||
| State the disease,injury or complication which caused death, not the mode ofdying such as heart failure, asthenia, etc. | (a)....................................................dueto (or as a consequences of) |
| Morbid conditions,if any giving rise to the above Cause, stating underlyingconditions last | (b).........................................................dueto (or as a consequences of)(c)........................................................ |
1. Yes 2. No.If yes, was there a delivery? 1. Yes 2. No.
| Howdid the injury occur?|-| Nameand Signature of the Medical Attendant certifying the cause ofdeathDate ofverification..............................................................................................|-| See Reverse for Instructions|-| (To be detached and handed over to the relative ofthe deceased)Certifying that Shri/Smt./Kum ............................. S/W/Dof Shri.................................... R/O..................was admitted to this hospital on….......................…...................... andexpired on …................Doctor................................................(MedicalSupdt. Name of Hospital)|}Medical Certificate of Cause of DeathDirections for completing the formName of deceased:- To be given in full. Do not use initials. If deceased is an infant, not yet named at time of 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 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.Cause of Death:- This part of the form should always be completed by the attending physician personally.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 on line (a) of Part I, and nothing more need be written in the rest of Part I or in Part II, or example, small pox, 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 then complete 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. heart failure, respiratory failure, etc. These terms should not appear on the certificate at all since they are modes of dying and not causes of death. Next consider whether the immediate cause is a complication or delayed result of some other cause. If so, enter the antecedent cause in Part I, line (b). Sometimes there will be three stages in the course of events leading to death. If so, line (c) will be completed. The underlying cause to be tabulated is always written last in Part I.Morbid conditions or injuries may be present which were not directly related to the train of events causing death but which contributed in some way to the fatal outcome. Sometimes the doctor finds it difficult to decide, especially for infant death, which of several independent conditions was the primary cause of death; but only one cause can be tabulated, so the doctor must decide. If the other diseases are not effects 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 the certificates as legibly as possible to avoid the risk of their being misread.Onset:- Complete the column for interval between onset and death whenever possible, even if very approximately, e.g. "from birth" "several years".Accidental or violent deaths:- Both the external cause and the nature of the injury are needed and should be stated. The doctor or hospital should always be able to describe the injury, stating the part of the body injured, and should give the external cause in full when this is shown. Example: (a) Hypo-static pneumonia; (b) Fracture of neck of femur; (c) Fall from ladder at home.Maternal deaths:- Be sure to answer the questions on pregnancy and delivery. This information is needed for all women of child-bearing age, even though the pregnancy may have had nothing to do with the death.Old age or senility:- Old age (or senility) should be not given as a cause of death if a more specific cause is known. If old age was a contributory factor, it should be entered in Part II. Example: (a) Chronic bronchitis, II old age.Completeness of information:- A complete case history is not wanted, but, if the information is available, enough details should be given to enable the underlying cause to be properly classified.Example:- Anaemia-Give type of anaemia, if known. Neoplasms-Indicate whether benign or malignant, and site, with site of primary neoplasm, whenever possible, Heart disease-Describe the condition specifically; if congestive heart failure, chronic on pulmonale, etc., are mentioned, give the antecedent conditions. Tetanus-Describe the antecedent injury, if known. Operation-State the condition for which the operation was performed. Dysentery-Specify whether bacillary, amoebic, etc., if known. Complications of pregnancy or delivery-Describe the complication specifically Tuberculosis-Give organs affected.Symptomatic statement:- Convulsions, diarrhoea, fever, ascites, jaundice, debility etc., are symptoms which may be due to any one of a number of different conditions. Sometimes nothing more is known, but whenever 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 of death is known, but it is not known whether it was the result of an accident suicide or homicide and is subject to further investigation, the cause of death should invariably be filled in and the manner of death should be shown as 'Pending investigation'.Form No. 4A[See Rule 7]Medical Certificate of Cause of Death(For non-institutional deaths. Not to be used for still births)To be sent to Registrar along with Form No. 2 (Death Report)I hereby certify that the deceased Shri/Smt./Kum. ......................................... son of/wife of/daughter of ..................... .............. resident of ................................ was under my treatment from ..................... to .................... and he/she died 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 | |||
| Causeof DeathI.Immediate cause{| | |||
| State the disease,injury or complication which caused death, not the mode ofdying such as heart failure, asthenia, etc. | (a)....................................................dueto (or as a consequences of) |
| Morbid conditions,if any giving rise to the above Cause, stating underlyingconditions last | (b).........................................................dueto (or as a consequences of)(c)........................................................ |
1. Yes 2. No.If yes, was there a delivery? 1. Yes 2. No.
|-| Nameand Signature of the Medical Practitioner certifying the cause ofdeathDate ofcertification..............................................................................................|-| See Reverse for Instructions|-| (To be detached and handed over to the relative ofthe deceased)Certifying that Shri/Smt./Kum ............................. S/W/Dof Shri.................................... R/O..................was under my treatment from…....................... to …......................and he/she expired on ….............. at .................a.m./p.m.Doctor.....................................................................Signatureand address of Medical Practitioner/Medical attendant withRegistration No. …......|}Medical Certificate of Cause of DeathDirections for completing the formName of deceased: To be given in full. Do not use initials. If deceased is an infant, not yet named at time of 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 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.Cause of Death: This part of the form should always be completed by the attending physician personally.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 on line (a) of Part I, and nothing more need be written in the rest of Part I or in Part II, for example, small pox, 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 then complete 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., heart failure, respiratory failure etc. These terms should not appear on the certificate at all since they are modes of dying and not causes of death. Next consider whether the immediate cause is a complication or delayed result of some other cause. If so, enter the antecedent cause in Part I, line (b). Sometimes there will be three stages in the course of events leading to death. If so, line (c) will be completed. The underlying cause to be tabulated is always written last in part I.Morbid conditions or injuries may be present which were not directly related to the train of events causing death but which contributed in some way to the fatal outcome. Sometimes the doctor finds it difficult to decide, especially for infant deaths, which of several independent conditions was the primary cause of death; but only one cause can be tabulated, so the doctor must decide. If the other diseases are not effects 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 the certificates as legibly as possible to avoid the risk of their being misread.Onset: Complete the column for interval between onset and death whenever possible, even if very approximately, e.g., "from birth" "several years".Accidental or violent deaths: Both the external cause and the nature of the injury are needed and should be stated. The doctor or hospital should always be able to describe the injury, stating the part of the body injured, and should give the external cause in full when this is shown. Example: (a) Hypo-static pneumonia; (b) Fracture of neck of femur, (c) Fall from ladder at home.Maternal deaths: Be sure to answer the questions on pregnancy and delivery. This information is needed for all women of child-bearing age, even though the pregnancy may have had nothing to do with the death.Old age or senility: Old age (or senility) should be not given as a cause of death if a more specific cause is known. If old age was a contributory factor, it should be entered in Part II. Example: (a) Chronic bronchitis, II old age.Completeness of Information: A complete case history is not wanted, but, if the information is available, enough details should be given to enable the underlying cause to be properly classified.Example: Anaemia-Give type of anaemia, if known. Neoplasms-Indicate whether benign or malignant, and site, with site of primary neoplasm, whenever possible, Heart disease-Describe the condition specifically; if congestive heart failure, chronic on pulmonale, etc., are mentioned, give the antecedent conditions. Tetanus-Describe the antecedent injury, if known. Operation-State the condition for which the operation was performed. Dysentery-Specify whether bacillary, amoebic, etc., if known. Complications of pregnancy or delivery-Describe the complication specifically Tuberculosis-Give organs affected.Symptomatic statement: Convulsions, diarrhoea, fever, ascites, jaundice, debility etc., are symptoms which may be due to any one of a number of different conditions. Sometimes nothing more is known, but whenever possible, give the disease which caused the symptom.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 Tahsil .................. of District .................... of State ...................Name ........................................Sex ............................................Date of Birth ............................Place of Birth ...........................Name of Father .......................Name of Mother .....................Registration No ......................Date of Registration ...............Date ..........................................Signature of issuing authoritySealForm No. 6(See Rule 8)Death 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 Tahsil .................. of District .................. of State ................Name ........................................Sex ............................................Date of Death ..........................Place of Death .........................Registration No .......................Date of Registration ................Date ..........................................Signature of issuing authority.SealNo 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 RegisterBirth ReportLegal InformationThis part to be added to the Birth Register To be filled by the informant1. Date of Birth:- (Enter the exact day, month and year the child was born e.g. 1-1-2000).
2. Sex: (Enter "male" or "female"; 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).5. Name of the mother:
(Full name as usually written).6. Place of birth:
(Tick the appropriate entry 1 or 2 below and give the name of the Hospital/ Institution or the address of the house where the birth took place).1. Hospital/Institution Name:
2. House Address:
7. Informant's name:
Address:(After completing all columns 1 to 20, informant will put date and signature here:).Date:Signature or left thumb mark of the informantTo be filled by the RegistrarRegistration No.: Registration Date:Registration Unit:Town/Village:District:Remarks: (if any).Name and Signature of the RegistrarForm No. 8(See Rule 12)Death RegisterDeath ReportLegal InformationThis part to be added to the Death Register To be filled by the informant1. Date of Death: (Enter the exact day, month and year the death took place e.g. 1-1-2000).
2. Name of the Deceased:
(Full name as usually written)3. Sex of the deceased: (Enter "male" or "female", do not use abbreviation)
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)5. Place of Death:
(Tick the appropriate entry 1, 2 or 3 below and give the name of the Hospital/ Institution or the address of the house where the death took place. If other place, give location)1. Hospital/Institution Name:
2. House Address:
3. Other Place
6. Informant's name:
Address:(After completing all columns 1 to 17, informant will put date and signature here:)Date:Signature or left thumb mark of the informantTo be filled by the RegistrarRegistration No.: Registration Date:Registration Unit:Town/Village:District:Remarks: (if any).Name and Signature of the RegistrarForm No. 9(See Rule 12)Still Birth RegisterForm No. 3Still Birth ReportLegal InformationThis part to be added to the Still Birth RegisterTo be filled by the informant1. Date of Birth:
(Enter the exact day, month and year e.g. 1-1-2000)2. Sex: (Enter "male" or "female")
(Do not use abbreviation)3. Name of the father:
(Full name as usually written)4. Name of the mother:
(Full name as usually written)5. Place of birth:
(Tick the appropriate entry below and give the name of the Hospital/Institution or the address of the House where the birth took place)1. Hospital/Institution Name:
2. House Address:
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 RegistrarRegistration No.: Registration Date:Registration Unit:Town/Village:District:Remarks: (if any).Name and Signature of the RegistrarForm 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 (Tahsil) .............. 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 authoritySeal.Form No. 11(See Rule 14)Summary Monthly Report of Births1. Report for the Month of .................... Year .................
2. District:
3. Town/Village:
4. Registration Unit:
5. Number of Births Registered:
1. Report for the Month of: ................... Year ..............
2. District :
3. Town/Village :
4. Registration Unit :
5. Details of Deaths Registered during the Month :
| Deaths | Infant Deaths | Maternal Deaths | ||
| Registered within one year of occurrence | Registered after one year of occurrence | Total* | ||
| 1 | 2 | 3 | 4 | 5 |
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 Birth Report Forms (Form No. 3) attached with this monthly report.Signature & Name of the RegistrarDated:Submitted to the Chief Registrar/District Registrar.Form No. 14Inspection Report| 1. Particulars of the Registration Unit: | |
| (a) Name: | |
| (b) District/Mandal/Village/GramPanchayat/Municipality: | |
| (c) Rural/Urban: | |
| (d) Population: | |
| (e) Area: | |
| (f) Whether the registration unithas a board? | Yes/No |
| 2. Functioning of registration unit: | |
| (a) Name of Registrar: | |
| (b) Whether Trained? | Yes/No |
| (c) Whether jurisdiction of theregistration centre is demarcated? | Yes/No |
| (d) Whether the notional map of theregistration unit is kept? | Yes/No |
| (e) Whether blank registers andother forms are kept: stock lasting for a year/half-year/3months/less than 3 months? | |
| (f) Whether a list of notifiers ismaintained? | Yes/No |
| (g) Whether a list ofhospitals/jails and other institutions is maintained? | Yes/No |
| (h) Whether a copy of theAct/Rules/Executives instructions are kept handy? | Yes/No |
| (i) Whether the norm on expectednumber of events supplied by the Chief Registrar is readilyavailable? | Yes/No |
| 3. Registering Performance: | |
| (a) Whether each register beginsfrom January and all pages are given serial numbers? | Yes/No |
| (b) Whether registration recordsare generally kept neat and clean? | Yes/No |
| (c) Whether records are kept insafe custody? | Yes/No |
| (d) Whether events reported areregistered promptly? | Yes/No |
| (e) Whether late and delayed eventsare registered according to rules and instructions? | Yes/No |
| (Please ensure that letter "D"or its regional equivalent is added before the serial Nos. ofdelayed events not relating to the year of reporting) | |
| (f) Whether corrections, if any aremade in the manner prescribed? | Yes/No |
| (g) Whether follow up action istaken on the information received from notifiers? | Yes/No |
| (h) No. of Institutions reportingthe vital events: | |
| (i) Regularly | |
| (ii) Occasionally | |
| (iii) Never | |
| (i) Date of sending of the lastreturns: | Yes/No |
| (j) No. of returns due but notsent: | |
| (k) Whether medical certificatesare linked and sent along with the return? | Yes/No |
| (l) Whether record relating toprevious years have been sent to the concerned officer? | Yes/No |
| 4. Remarks of the Inspecting Officers: | |
| (a) Date of Inspection: | |
| (b) Date of last inspection: | |
| (c) No. of spot verification made:.................. | |
| Births .............. Still Births................ Deaths ............. | |
| (d) No. of the events detectedwhich are not recorded: .................. | |
| Births .............. Still Births................ Deaths ............. | |
| (e) No. of events found registeredwhich did not occur: ................. | |
| Within the jurisdiction of theregistration units. | |
| (f) Total No. of cumulative eventsregistered: ................... | |
| Births .............. Still Births................ Deaths ............. | |
| (g) Whether these are consistentwith the norms provided? | |
| (h) Overall assessment:....................... | |
| VeryGood/Satisfactory/Unsatisfactory | |
| (i) Specific instructions if any,given to the registrar: |