Rajasthan Registration of Births &
Deaths Rules, 2000
In exercise of powers conferred by section 30 of
the Registration of Births and Deaths Act, 1969 (Central Act No. 18 of 1969),
the State Government with the approval of the Central Government, hereby makes
the following rules, namely:-
In exercise of the powers conferred by
Section 30 of the Registration of Births and Deaths Act, 1969 (Central Act No.
18 of 1969), the State Government with the approval of the Central Government,
hereby makes the following rules, namely:-
Rule - 1. Short title, extent and commencement.?
(a)
These rules may be called the Rajasthan
Registration of Births and Deaths Rules, 2000
(b)
These rules extend to the whole State of Rajasthan
(c)
These rules shall come into force from the date of
their publication in the Official Gazette.
Rule - 2. Definitions.?
In these rules, unless the context
otherwise requires-
(a)
"Act" means the Registration of
Births and Deaths Act, 1969;
(b)
"Form" means a form appended to
these rules; and
(c)
"Section" means a section of the
Act.
Rule - 3. Period of gestation.?
The period of gestation for the
purposes of clause (g) of sub-section (1) of Section 2 shall be twenty eight
weeks.
Rule - 4. Submission of report.?
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 preferred 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.
Rule - 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 orally shall be entered by the Registrar in the
appropriate reporting forms and the signature/thumb impression of the
information obtained.
(2)
The information referred to in sub-rule (1) shall
be given within twenty one days from the date of birth, deaths and still birth.
(3)
The part of the reporting forms containing legal
information shall be called the "Legal Part" and the part containing
statistical information shall be called the "Statistical Part"
Rule - 6. Persons required to register birth and death under Section 8(1)(f).?
(1)
In respect of a birth or death in 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.
"If the person in charge of the vehicle does not give the information of a
death in a moving vehicle at the first place of halt, in such case registration
of the event of death should be done at the place where the deceased has been
cremated."
Explanation. - For the purpose of
this rule, the term "vehicle" means conveyance of any kind used on
land, air or water and includes a aircraft, an boat, a ship, a railway
carriage, a motor car, a motor cycle, a cart, a tanga and rickshaw.
(2)
In the 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.
Rule - 7. Form of certificate as to the cause of death 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 4-A as the case may be, and the Registrar shall, after making necessary
entries in the register of death, 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.
Rule - 8. Extracts of registration entries to be given under 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 domiciliary 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 house or
households as the case may be, or in his absence the nearest relative of the
head present in the house may collect the extracts of births or deaths from the
Registrar within thirty days of its reporting .
(3)
In the case of domiciliary events of births and
deaths referred to in clause (a) of sub-Section (1) of Section 8 which are
reported by the persons specified by the State Government under sub-Section (2)
of the said section, the persons so specified shall transmit the extracts received
from the Registrar of Births or 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 in charge of
the concerned institutions 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.
Rule - 9. Authority for delayed registration and fee payable therefor.?
(i)
Any birth or death or 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.
(ii)
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 District Registrar and on
payment of a late fee of rupees five and on production of an affidavit made
before a Notary Public or any other officer authorised in this behalf.
(iii)
Any birth or death which has not been registered
within one year, of its occurrence, shall be registered only on an order of a
Executive Magistrate and on payment of late fee of rupees ten.
Rule - 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 Rajasthan Registration of Births and Deaths
(Amendment) Rules, 1980 from such date, or
(ii)
In case where the registration is made after the
date of commencement of the Rajasthan 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, the Registrar shall-
(a)
If the register is in his possession forth-with
enter the name in the relevant column of the concerned form in the birth
register on payment of 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 District Registrar
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 take action as laid down in clause (b) of the proviso to
sub-rule (1).
Rule - 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 District Registrar.
(2)
In the case referred to in sub-rule (1) if the
register is not in his possession, the Registrar shall make a report to the
State Government or the officer specified by it in this behalf and call for
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 countersigned by the State Government or the officer specified by it
in this behalf when the register is 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 as provided in 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 of any correction of the kind
referred to therein giving necessary details to the State Government or the
officer specified in this behalf.
(6)
If it is proved to the satisfaction of the
Registrar that any entry in the Register of Births & 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
specified 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.
Rule - 12. Form of register under Section 16.?
The legal part of the Forms No. 1,2
& 3 shall constitute the births register, deaths register and still birth
register (Forms No. 7, 8 & 9) respectively.
Rule - 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.-
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(a)
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search for a single entry in the
first year for which the search is made
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Rs. 2.00
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(b)
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for every additional year for which
the search is continued
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Rs. 2.00
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(c)
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for granting extract relating to each
birth or death
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Rs. 5.00
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(d)
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for granting non-availability
certificate of birth or death
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Rs. 2.00
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(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 Form No. 6, as the case may be, and
shall be certified as provided in Section 76 of the Indian Evidence Act, 1872
(1 of 1872).
(3)
If any particular event of birth or death is not
found registered the Registrar shall issue a non-availability certificate in
Form No. 10.
(4)
If such extracts or non-availability certificate
may be furnished to the person asking for it or send to him by post on payment
of Rs. 20/- as the postal charges therefor.
Rule - 14. Interval and forms of periodical returns under Section 19.?
(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 specified by him on or before the 5th of the following month.
(2)
The officer so specified shall forward all such
Statistical Parts of the reporting Forms received by him to Chief Registrar not
later than the 10th of the month.
Rule - 15. Statistical report under Section 19(2).?
The Statistical report under
sub-Section (2) of Section 19 shall contain the tables in the prescribed format
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.
Rule - 16. Conditions for compounding of offences.?
(1)
Any offence punishable under Section 23 may, either
before or after the institution of criminal proceedings under this 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 or for the first
time.
(2)
Any such offence may be compounded on payment of
such sum, not exceeding rupees fifty for offences under sub-secs. (1), (2)and
(3), and rupees ten for offences under sub?Section(4), of the Section 23 as the
said officer may think fit.
Rule - 17. Registers and other records under Section 30 (2) (k).?
(1)
The birth register, death register and still birth
register shall be a records of permanent importance and shall not be destroyed.
(2)
The Court orders and the orders of the specified
authorities granting permission for delayed registration received under Section
13 by the Registrar, shall form an integral part of the birth register, death
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 at least
5 years by the Chief Registrar or the officer specified by him in his 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 as
such register shall thereafter, be transferred for safe custody to the District
Registrar.
Rule - 18. Fees.?
All fees payable under the Act may be
paid in cash or money order or postal order.
Rule - 19. Repeal and saving.?
As from the coming into force of these
rules, the Registration of Births and Deaths Rules, 1972 shall stand repealed:-
Provided that any order made or action
taken under the rules so repealed shall be deemed to have been made or taken
under 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 or births and deaths.
8.
Progress in the medical certification of cause of
death.
9.
Maintenance of Records.
10.
Search of birth and death 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]
Legal Information
This part to be added to the Birth
Register
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To be filled by the informant
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1
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Date of Birth : (Enter the exact
day, month and year, the child was born e.g. 1.1.2000)
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2
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Sex : (Enter "male" or
"female", do not use abbreviation)
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3
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Name of the child, if any : (if
not named, leave blank)
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4
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Name of the father :
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(Full name as usually written)
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5
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Name of the mother :
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(Full name as usually written)
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6
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Permanent address of the Parents:
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7
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Address of Parents at the time of
birth :
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8
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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)
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1. Hospital/Institution
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Name :
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2. House
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Address:
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9
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Informant's name :
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Address :
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(After completing all columns 1 to
22, informant will put date and signature here :)
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Date :
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Signature or left thumb mark of the
informant
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To be filled by the Registrar
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Registration No.
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Registration Date :
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Registration Unit:
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Town/Village :
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District:
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Remarks : (if any)
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Name and Signature of the Registrar
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[Form
No. 1]
[See
Rule 5]
Birth
Report
Statistical
Information
This part to be detached and sent for
statistical processing
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To be filled by the informant
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To be detached and sent for
statistical processing
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10
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Town or
Village of Residence of the mother : (place
where the mother usually to lives. This can be different from the place where
the delivery occurred. The house address is not required to be entered).
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(a) Name of town/Village:
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(b) Is it town or village : (Tick the
appropriate entry below)
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1. Town 2. Village
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? Name of District :
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(d) Name of State :
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11
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Religion of
the Family : (Tick the appropriate entry below)
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1. Hindu 2. Muslim 3. Christian
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4. Any other religion : (write name
of the religion)
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12
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Father?s level
of education : (Enter the completed level of education
e.g. if studied up to class VII but passed only class VI, write class VI.)
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13
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Mother?s level
of education : (Enter the completed level of
education e.g. if studied up to class VII but passed only class VI, write
class VI.)
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14
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Father?s
occupation : (if no occupation write Nil)
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15
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Mother?s
occupation : (if no occupation write Nil)
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To be filed by the Registrar
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Name
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Code No.
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District:
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Tahsil:
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Town/Village :
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Registration Unit:
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In the case of multiple births, fill
in a separate form for each child and write ?Twin birth? or ?Triple birth?
etc., as the case may be, in the remarks column in the box below left.
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16
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Age of mother
(in completed years) at the time of marriage : (If married
more than once, age at first marriage may be entered)
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17
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Age of the
mother (in completed years) at the time of this birth :
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18
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Number of
children born alive to the mother so far including this child : (Number of children born alive to include also those from
earlier marriage(s), if any)
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19
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Type of
attention at delivery : (Tick the appropriate entry below)
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1. Institutional-Government
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2. Institutional-Private or
Non-Government
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3. Doctor, Nurse or Trained midwife
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4. Traditional Birth Attendant
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5. Relatives or Others.
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20
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Method of Delivery : (Tick the
appropriate entry below)
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1. Natural 2. Caesarean 3.
Forceps/Vacuum
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21
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Birth Weight (in kgs) : (if
available)
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22
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Duration of pregnancy : (in weeks)
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(Columns to be filled are over, now put signature at left)
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Registration No.
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Registration Date :
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Date of Birth :
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Sex 1. Male 2. Female
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Place of Birth : 1. Hospital/Institution 2. House
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Name and Signature of the Registrar
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[DEATH
REPORT]
Legal Information
This part to be added to the Death Register
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To be filled by the informant
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1
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Date of Death : (Enter the exact
day, month and year, the death took place e.g. 1.1.2000)
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2
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Name of the Deceased : (Full
name as usually written)
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3
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Sex of the deceased : (Enter
"male" or "female", do not use abbreviation)
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4
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Name of the Father/Husband of the
deceased:
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(Full name as usually written)
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5
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Name of the mother of the deceased :
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(Full name as usually written)
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6
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Permanent address of the deceased:
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7
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Address of the deceased at the time
of death :
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8
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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)
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9
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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)
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1. Hospital/Institution
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Name :
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2. House
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Address:
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3. Other places :
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10
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Informant's name :
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Address :
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(After completing all columns 1 to
21, informant will put date and signature here :)
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Date :
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Signature or left thumb mark of the
informant
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To be filled by the Registrar
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Registration No.
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Registration Date :
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Registration Unit :
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Town Village :
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District :
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Name and Signature of the Registrar
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[Form
No. 2]
[See
Rule 5]
Death
Report
Statistical
Information
This part to be detached and sent for
statistical processing
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To be filled by the informant
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To be detached and sent for
Statistical processing
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11
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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).
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(a) Name of town/Village:
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(b) Is it town or village : (Tick the
appropriate entry below)
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1. Town 2. Village
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(c) Name of District :
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(d) Name of State:
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12
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Religion : (Tick the appropriate
entry below)
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1. Hindu 2. Muslim 3. Christian 4.
Any other religion : (write name of the religion)
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13
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Occupation of the deceased : (If
no occupation write ?Nil?)
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14
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Type of medical attention received
before Death : (Tick the appropriate entry below)
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1. Institutional
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2. Medical attention other than institution
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3. No medical attention
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No.
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Name
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Code
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District:
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Tahsil:
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Town/Village Registration Unit:
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To be filled by the informant
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15
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Was the cause of death medically
certified ?: (Tick the appropriate entry below)
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1. Yes 2. No
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16
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Name of Disease or Actual Cause of
Death :
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(For all deaths irrespective of
whether medically certified or not)
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17
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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 :
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(Tick the appropriate entry below)
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1. Yes 2. No
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18
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If used to habitually smoke-for how
many years ?:
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19
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If used to habitually chew tobacco in
any form for how many years ?:
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20
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If used to habitually chew areca nut
in any form (including pan masala)-for how many years ?:
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21
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If used to habitually drink
alcohol-for how many years ?:
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(Columns to be filled are over. Now
put signature at left)
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To be filled by the Register
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Registration No.
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Registration Date :
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Date of Birth :
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Sex 1. Male 2. Female
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Age: Years/months/days/hours
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Place of Death :
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1. Hospital/Institution 2. House
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3. Other Place
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Name and Signature of the Registrar
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Form
No. 3
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Still Birth
Report
Legal Information
The part to be added to the Death Register
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Still Birth
Report
Statistical Information
This part to be detached and sent for statistical processing
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In the case of multiple, births, fill
in a separate form for each Child & writ "Twin birth" or
"Triple birth" etc. as the case may be, in the remarks column in
the box below left.
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To be filled by the informant
1.Date of Birth: (Enter the exact
day, month and year the Birth took place 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.
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1.
Hospital/Institution
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Name :
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2. House
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Address :
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6. Informant's Name:
Address
(After completing all columns 1 to 20, information will put date and
signature here:)
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Date
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Signature or
left thumb mark of the informant
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To be filled by the informant
7. Town or Village or Residence of
the mother: (Place where the mother usually lives. This can be different from
the place where the delivery occurred. The House address is not required to
be entered)
(a) Name of Town or Village :
(b) Is it a town or village : (tick the appropriate 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 e.g.
if studied upto class VII but passed only class VI, write class VI
10. Type of attention at delivery
:(Tick the appropriate entry below)
1.
Institutional-Governmental
2. Institutional-Private or Non-Government
3. Doctor, Nurse or Trained midwife
4. Traditional Birth Attendant
5. Relative or others
11. Duration of pregnancy : (In
weeks)
12. Cause of foetal death : (if known)
(column to be filled are over. Now
put signature at left)
|
|
To be filled by the Registrar
|
To be filled by the Registrar
|
|
|
Registration No.:
Registration Unit
Town/Village :
Remarks (if any)
|
Registration Date :
|
Name
|
Code No.
|
Registration No.:
Registration Date :
Date of Birth
Sex : 1. Male 2. Female
|
|
|
District
Tehsil
Town/Village
|
|
|
District :
|
|
|
Place of Birth:
|
1. Hospital/Institution
|
2. House
|
|
|
Name and Signature of the Registrar
|
Registration Unit
|
Name and Signature of the Registrar
|
|
Form
No. 4
[See
Rule 7]
Medical
Certificate of Cause Of Death
(Patient in Hospital, not to be used
for still births)
To be sent to Registrar along with 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 of Death
|
|
If 1 year or more
|
If less than 1 year
|
If less than one Month, age in Days
|
If less than one day, age in hours
|
|
1. Male
2. Female
|
Cause of Death
|
Interval between onset & death
appropriates
|
|
I.
Immediate cause
State the disease, injury or Due to (or as a consequences of) complication
which caused death, not the mode of dying such as heart failure, Asthenia,
etc.
Antecedent cause
Morbid conditions, if any, giving Due to (or as consequences of ) rise to the
above cause, stating Under lying conditions last
II.
Other significant conditions contributing to the death but not related to
the disease or conditions causing it.
|
(a)
?..............................................
Due to (or as a consequences of)
(b) ?.............................................
Due to (or consequences of)
(c)
?.............................................
?................................................
?..................................................
|
|
Manner of Death
|
How did the injury occur ?
|
|
1. Natural 2.Accident 3. Suicide 4.
Homicide 5. Pending investigation if deceased was a female, was pregnancy the
death associated with ?
If yes, was there a delivery ?
1. Yes 2. No.
death
|
1. Yes 2. No
Name and signature of the Medical Attendant
certifying the cause 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./Kum..................S/W/D of Shri
....................................
R/O ..................was admitted to
this hospital on.................. and expired on ..................
Doctor ..................
(Medical Supdt. Name of Hospital)
Medical Certificate Of Cause Of Death
Directions for completing the form
Name 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) or part I, and nothing more need
be written in the rest or Part I or in Part II, for example, smallpox, 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) Hypostatic peneumonia; (b)
Fracture of neck of femur; (e) 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
not be 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.
Completness 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. Dysentry-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 cause 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
invaribly be filled in and the manner of death should be shown as "Pending
investigation".
Form
No. 4-A
[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)
|
Name of Deceased
|
|
For use of Statistical office
|
|
Sex
|
Age of 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. Male
2. Female
|
Cause of Death
|
Interval between onset & death
approx.
|
|
I.
Immediate cause
State the
disease, injury or Due to (or as a consequences of) complication which caused
death, not the mode of dying such as heart failure, Asthenia, etc.
Antecedent cause
Morbid
conditions, if any, giving Due to (or as consequences of ) rise to the above
cause, stating Under lying conditions last
II.
Other significant conditions contributing to the death but not related
to the disease or conditions causing it.
|
(a)
?..............................................
Due to (or as a consequences of)
(b)
?.............................................
Due to (or consequences of)
(c)
?.............................................
?....?......................................
.......?......................................
.......?......................................
|
|
If deceased was a female, was
pregnancy the death associated with ? If yes, was there a delivery ? 1. Yes
2. No.
|
|
Name and signature of the Medical
Practitioner certifying the cause of death
Date of Certification ?........................
|
|
See Reverse For Instruction
|
|
(To be detached and handed over to
the relative of the deceased)
Certified that Shri/Smt./Kum.................. S/W/D of
Shri.................. R/o.................. was under my treatment
from.................. and he/she expired on.................. at..................
A.M./P.M.
Doctor........................................................................
Signautre and address of MedicalPractitioner/Medical attendant with
Registration No.
|
Medical Certificate Of Cause Of Death
Directions for completing the form
Name 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
years 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,
line (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, smallpox, 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 under lying
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 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) Hypostatic 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
not be given as a cause of death if a more specific cause is known.If old age
was a contributory factor, if 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. Dysentry -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.
|
Ikzk:i la 5
|
|
[FORM NO. 5]
|
|
TkUe izek.k i=
|
|
BIRTH
CERTIFICATE
|
|
(tUe vkSj e`R;q jftLVzhdj.k vf/kfu;e
1969 dh /kkajk 12/17 vkSj jktLFkku tUe vkSj e`R;q jftLVzhdj.k fu;e
2000 ds fu;e 8/13 ds v/khu tkjh fd;k x;k
|
|
(Issued under Sec. 12/17 of the
Registration of Births and Deaths Act, 1969 and Rule 8/13 of the Rajasthan
Registration of Births and Deaths Rules, 2000)
|
|
;g izekf.kr fd;k tkrk gS fd
fuEufyf[kr lwpuk e`R;q ds ewy vfHkys[k ls yh xbZ gS tks fd (LFkkuh;
{ks=/LFkkuh;
fudk;)...............rglhy/[k.M?............ftyk..............jkT;/ la?k
jkT; {ks=?...............dk jftLVj gSA
|
|
This is to certify that the following
information has been taken from the original record of death which is the
register for (local area/local body)........... of
tehsil/block................of District............... ?...........of
State/Union territory.
|
|
uke/Name............................................................................................................
|
|
fyax/Sex:.................................e`R;q
frfFk/Date of Death:.........................................
|
|
e`R;q LFkku/Place of
Death:....................ekrk dk uke/Name of Mother:....................
|
|
firk/ifr dk uke/Name of
Father/Husband:...........................................................
|
|
e`rd dk e`R;q ds le; dk irk/Address
of the e`rd dk LFkk;h irk/ deceased at the time of death: Permanent
address of deceased:...............................
|
|
?...................................................................................................................
|
|
?...................................................................................................................
|
|
jftVzdj.k la./Registration
No................jftLVzhdj.ka dh rkjh[k/Date of
Registration............................
|
|
fVIi.kh/Remarks (if
any):..................................................................................
|
|
tkjh djus dh rkjh[k/Date of
issue.....................................................................
|
|
tkjh djus okys izkf/kdkjh ds
gLrk{kj/Signature of the issuing authority
|
|
tkjh djus okys izkf/kdkjh dk
irk/Address of the issuing authority
|
|
eqgj/Seal
|
|
Ikzk:i la 6
|
|
[FORM NO. 6]
|
|
e`R;q izek.k
i=
|
|
DEATH
CERTIFICATE
|
|
(tUe vkSj e`R;q jftLVzhdj.k vf/kfu;e
1969 dh /kkajk 12/17 vkSj jktLFkku tUe vkSj e`R;q jftLVzhdj.k fu;e
2000 ds fu;e 8/13 ds v/khu tkjh fd;k x;k
|
|
(Issued under Sec. 12/17 of the
Registration of Births and Deaths Act, 1969 and Rule 8/13 of the Rajasthan
Registration of Births and Deaths Rules, 2000)
|
|
;g izekf.kr fd;k tkrk gS fd
fuEufyf[kr lwpuk e`R;q ds ewy vfHkys[k ls yh xbZ gS tks fd (LFkkuh;
{ks=/LFkkuh; fudk;)...............rglhy/[k.M?............ftyk..............jkT;/ la?k
jkT; {ks=?...............dk jftLVj gSA
|
|
This is to certify that the following
information has been taken from the original record of death which is the
register for (local area/local body)........... of tehsil/block................of
District............... of State/Union territory.
|
|
uke/Name...........................................................................................................
|
|
fyax/Sex:.................................e`R;q
frfFk/Date of Death:.........................................
|
|
e`R;q LFkku/Place of
Death:....................ekrk dk uke/Name of Mother:....................
|
|
firk/ifr dk uke/Name of
Father/Husband:...........................................................
|
|
e`rd dk e`R;q ds le; dk irk/Address
of the e`rd dk LFkk;h irk/ deceased at the time of death: Permanent
address of deceased:...............................
|
|
?...................................................................................................................
|
|
?...................................................................................................................
|
|
jftVzdj.k la./Registration
No................jftLVzhdj.ka dh rkjh[k/Date of
Registration............................
|
|
fVIi.kh/Remarks (if
any):..................................................................................
|
|
tkjh djus dh rkjh[k/Date of
issue.....................................................................
|
|
tkjh djus okys izkf/kdkjh ds gLrk{kj/Signature
of the issuing authority
|
|
tkjh djus okys izkf/kdkjh dk
irk/Address of the issuing authority
|
|
eqgj/Seal
|
[Form
No. 7]
[See
Rule 12]
BIRTH
REGISTER
FORM
1 : 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
|
Permanent address of the Parents:
|
|
7
|
Address of Parents at the time of
birth :
|
|
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)
|
|
1. Hospital/Institution
|
Name :
|
|
2. House
|
Address:
|
|
9
|
Informant's name :
|
|
Address :
|
|
(After completing all columns 1 to
22, informant will put date and signature here :)
|
|
Date :
|
Signature or left thumb mark 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 Registrar
|
|
|
|
|
[Form
No. 8]
[See
Rule 12]
Death
Register
Form
No. 2 Death Report
Legal
information
This part to be added to the Death
Register
|
To be filled by the informant
|
|
1
|
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
|
Name of the Father/Husband of the
deceased:
|
|
(Full name as usually written)
|
|
5
|
Name of the mother of the deceased :
|
|
(Full name as usually written)
|
|
6
|
Permanent address of the deceased:
|
|
7
|
Address of the deceased at the time
of death :
|
|
8
|
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)
|
|
9
|
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 places :
|
|
|
10
|
Informant's name :
|
|
Address :
|
|
(After completing all columns 1 to
21, informant will put date and signature here :)
|
|
Date :
|
Signature or left thumb mark of the
informant
|
|
To be filled by the Registrar
|
|
Registration No.
|
Registration Date :
|
|
Registration Unit :
|
|
|
Town Village :
Remarks: (if any)
|
District :
|
|
Name and Signature of the Registrar
|
|
|
|
|
Form
No. 9
[See
Rule 12]
Form
No. 3
Still
Birth Register
Still
Birth Report
Legal information
This part to be added to the Still
Birth Register
To be filled by the informant
1.
Date of Birth : (Enter the exact day, month
and year e.g. 1.1.2000
2.
Sex :(Enter "male" or "female")
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
3.
Other place
4.
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
informant
To be filed by the Registrar
Registration Date :
Registration No.
Registration Unit :
Town/Village :
Remarks : (if any)
District :
Name and Signature of the Registrar
Form
No. 10
[See
Rule 13]
Non-Availability
Certificate
(Issued under Section 17 of the
Registration of Births & 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 authority
Seal
Form
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 their Occurrence:
(b)
After one year of their Occurrence :
Total (a+b)
Total should to equal to the number of
Statistical Part of Birth Reporting Forms (Form No. 1) attached with the
monthly report
Signature & Name of the Registrar
Dated :
Submitted to the Chief Registrar/District
Registrar.
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.
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
|
Note - Infant and Maternal Deaths
should also be included in the Deaths.
Total should be equal to number of Statistical
Part of Deaths Reporting Forms (Form No. 2) attached with this monthly report.
Signature & Name of the Registrar
Dated :
Submitted to the Chief
Registrar/District Registrar
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 Birth Report Forms (Form No. 3) attached
with this monthly report.
Signature & Name of the Registrar
Dated :
Submitted to the Chief
Registrar/District Registrar.