Public Service Form

Child Name Inclusion

Child name inclusion in birth register request without request type or acknowledgement number lookup fields.

Service charge Rs. 95.00 Total: Rs. 95.00 Payment collection placeholder

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Applicant detailsFields marked required must be completed.

Old Application Number

Registration Number

Child Name Required

Child Surname

Father Name

Mother Name

Gender

Date Of Birth

Circle

Ward

Locality

Place Of Birth

Address at Time of Birth

Permanent Address

Remarks

Informant Name Required

Relationship Required

Ration Card No

Aadhaar No

Address Required

Pincode Required

Mobile No Required

Email ID

Delivery Type Required

Purpose of Certificate Required

No of Copies Required

Application (Duly signed by both parents if Child is less than 3 Years) Required

Upload a clear file.

Birth Certificate Required

Upload a clear file.

Residence Proof Required

Upload a clear file.

Notary Affidavit on Rs.10/- Non-Judicial Stamped paper Required

Upload a clear file.

Review before submitting

Please confirm your details are correct before creating the application.

Application total: Rs. 95.00