CHANDIGARH ADMINISTRATION GOVERNMENT REGISTAR BIRTH & DEATH e-JAN SAMPARK AFFIDAVIT AFFIDAVIT FOR LATE REGISTRATION OF BIRTH I---------------------S/O resident of H.NO --------------------------------- do hereby Solemnly affirm and decline as under: 1. That a male /female child was born to my wife Mrs........... At..............................on ..............The order this male/female child is 2. That the said male/female child was finally names as.......... 3. That the delivery case was conducted by Dr./Dai..residence of H.No.. 4. That the said male/female child name is real and natural child of Mrs..... W/o sh.......has not been adopted by Mrs......... W/osh........or sh.........s/o sh........ Either through court sub Magistrate or otherwise. 5 That the said event of birth of male /female child has not been registered previously either by the deponent of Doctor or dai. 6 That the data and place of birth of this male/female child has not been changed /manipulated. 7 That the deponent prey for the registration of birth of this male/female child. DEPONENT VERIFICATION:- Verified that the above statement of mine are true and correct to the best of my knowledge and nothing has been concealed therein . Verified at Chandigarh on. DEPONENT e -JAN SAMPARK : Information Gateway of Chandigarh Administration : 1 of 1
