Mormugao Municipal Council: Applicable Forms Form No 7 Annexure-IX Form VII MORMUGAO MUNICIPAL COUNCIL BIRTH REPORT Legal Information This part to be added to the Birth Register To be filled by the informant 1. 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. Name of the grandfather : (father's side) .............................................................................................. 7. Name of the grandmother : (father's side) ........................................................................................... 8. 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) 9. 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 informant 1. Hospital/Institution Name : ...................................................................................................... 2. House Address : ........................................................................................................ ..... http://www.mmcvasco.com/annexure/annexure9.html (1 of 2) [3/16/2009 4:27:36 PM] Mormugao Municipal Council: Applicable Forms To be filled by the Registrar Registration No. : Registration Date: Registration Unit : Town/Village : District : Remarks : (If any) Name and Signature of the Registrar Click here to fill in the Statistical information Back to 'Certificate of Birth/Death' http://www.mmcvasco.com/annexure/annexure9.html (2 of 2) [3/16/2009 4:27:36 PM]
