THE TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS

RULES 2000

(As Amended upto 20.08.2019)

Government of Tamil Nadu

2019

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 THE TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS RULES 2000
ARRANGEMENTS OF RULES

Section under
Rules Subject
Which framed
1. Short title extent and commencement
2. Definitions
3. Period of Gestation 2(1) (g)
4. Submission of Reports 4(4)
5. Forms for giving information of births and deaths 8 or 9
6. Births or Deaths in a vehicle 8(1)
7. Notification and Form of Certificate 10(1)
8. Extracts of registration entries to be given 12
9. Authority for delayed registration and fee payable thereof 13(1)(2)(3)
10. Period for registration of name of the child 14
11. Correction or cancellation of entry in the register of births and 15
deaths
12. Form of Register 16
13. Fees and Postal Charges payable 17
14. Interval and forms of periodical returns 19(1)
15. Statistical report 19(2)
16. Conditions for compounding offences 23
17. The custody, production and transfer of registers and other records 30(2)(k)
kept by regards
18. Manner of payment of fees
Annexure
Forms 1 to 14B

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 (Published in Tamil Nadu Government Gazette Extraordinary No.976
Part III, Section 1(a)
dated 29.12.1999, Page No.1 to 6)

NOTIFICATIONS BY GOVERNMENT

HEALTH AND FAMILY WELFARE DEPARTMENT

TAMIL NADU REGISTRATION OF BIRTHS AND DEATHS RULES, 2000

(G.O.Ms.No. 528, Health and Family Welfare (AB-2), 29th December 1999)

No.SRO A-95(a)/99

In exercise of the powers conferred by section 30 of the Registration of Births and

Deaths Act, 1969 ( Central Act 18 of 1969) and in the suppression of the Tamil Nadu Births
and Deaths Registration Rules, 1977, the Governor of Tamil Nadu with the approval of the
Central Government hereby makes the following rules, namely:

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1. Short title, extent and commencement: (1) These rules may be called the Tamil Nadu
Registration of Births and Deaths Rules, 2000.
(2) These rules shall extend to the whole of the State of Tamil Nadu.
(3) They shall come into force on the 1st January 2000.
2. Definitions:- In these rules, unless the context otherwise requires:
(a) “Act” means the Registration of Births and Deaths Act, 1969 (Central Act 18 of 1969)
(b)“Form” means a Form appended to these rules,
(c) “Government” means the State Government,
(d) “Section” means a section of the Act.
(e) “Register” means Register of Births and Deaths.
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.
4. Submission of report under sub-section (4) of section 4 :– 1 [The report under sub-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].

5. Form 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 2[Forms
Nos.1, [1A]3,2 and 3] 2 for the Registration of a birth, adoption of child, death and still birth
respectively, herein after to be collectively called the reporting forms. Information, if given
orally shall be entered by the Registrar in the appropriate reporting form and the signature or
thumb impression of the informant obtained.

(2) The part of the reporting form containing legal information shall be called as “Legal
Part” and the part containing statistical information shall be called as “Statistical Part”.

(3) The information referred to in sub-rule (1) shall be given within twenty one days from
the date of birth, death or still birth.

1. The expression were substituted for the expression “Form 16”

2. The expression were substituted for the expression “Form 2, 3 and 4”
vide G.O.Ms.No.85 Health &Family Welfare (AB2)Department, dt.29.04.2003
3. The expression “Form 1A” included.
vide G.O.Ms.No.226 Health &Family Welfare (AB2)Department, dt.06.08.2015.

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6) Birth or Death in a vehicle: (1) In respect of a birth or death in a moving vehicle, the
person in-charge 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.
Explanation : For the purpose of this rule, the term “Vehicle” means conveyance of any kind
used on land, air or water and includes an aircraft, boat, ship, railway carriage, motor-car,
motor – cycle, cart, tonga 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.

7. Notification and Form of Certificate under section 10: (1) The certificate as to the cause
of death required under sub-section (3) of section 10 shall be issued in 1 [Form No.4 or 4A]
and the Registrar shall, after making necessary entries in the Register of Births and
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
certificate relates
(2) Any person who performs the funeral ceremonies of a person dying in a local area within
the jurisdiction of a municipality, panchayat or other local authority or any other area, shall
whenever required furnish to the Registrar such information as he possesses regarding the
particulars required for registration.
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 2[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 the house or household as the case may be, or in his absence, the nearest relative
of the head present in the house may collect the extracts of birth or death from the Registrar
within 30 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 persons specified by the State
Government under sub-section (2) of the said section, the person so specified shall transmit
the extracts received from the Registrar of Births and Deaths to the concerned head of
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.

1. These expressions were substituted for the expressions “5 or 5A”.

2. These expressions were substituted for the expressions “6 or 7”
vide G.O.Ms.No.85 Health &Family Welfare (AB2)Department, dt.29.04.2003

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 (4) In the case of institutional events of births and deaths referred to in clauses (b) and (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 institution 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.
9. Authority for delayed registration and fee payable thereof under section 13: (1) Any birth
or death of which information is given to the Registrar after the expiry of the period specified
in rule 5, but within 30 days of its occurrence shall be registered on payment of a late fee of
1
[rupees one hundred]
(2) Any birth or death of which information is given to the Registrar after thirty days but
within one year of its occurrence, shall in the case of the local authorities specified in column
(1) of the Table below, be registered only with the written permission of the officers specified
in the corresponding entries in column (2) thereof, on payment of a late fee of 2[rupees two
hundred].
TABLE
Local Authorities Officers
(1) (2)
Village Panchayat Village Panchayat President
Town Panchayat Executive Officer
Cantonment -Do-
Municipality Commissioner
Corporation -Do-
Neyveli Lignite Corporation Chief Health Officer

(3) 4[Any birth or death which has not been registered within one year of its occurrence
shall be registered by an order of the Executive Magistrate not below the rank of a Revenue
Divisional Officer] and on payment of late fee of 3[rupees Five hundred].
(4) Any person aggrieved by any order made under sub-rule 2, by the officers specified in
column (1) of the Table below may, within one month from the date of receipt of such order,
prefer an appeal against such order to the authorities specified in the corresponding entries in
column (2) thereof.
1. These words were substituted for the words “rupees Two”
2. These words were substituted for the words “rupees Five”
3. These words were substituted for the words “rupees Ten”
4. These words were substituted for the words
Any birth or death which has not been registered within year of its occurrence shall be registered by an
order of the “Judicial Magistrate or a Metropolitan Magistrate ”
vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.2017

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 TABLE
Local Authorities Officers
(1) (2)
Village Panchayat President
Revenue Divisional Officer
Executive Officer
Revenue Divisional Officer District Collector
Executive Officer, Cantonment -Do-
Commissioner of Municipality -Do-
District Collector Chief Registrar of Births and
Commissioner of Corporation Deaths
Chief Registrar of Births and Deaths Government

Provided that the appellate authority may in its discretion allow further time not
exceeding one month for preferring any such appeal if it is satisfied that the appellant has
sufficient cause for not preferring the appeal in time.
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 Tamil Nadu Registration of Births and Deaths Rules, 2000 from such date, or

(ii) in case where the registration is made after the date of commencement of the
Tamil Nadu Registration of Births and Deaths Rules, 2000 from the date of such
registration, subject to provisions of sub – section (4) of section 23.
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[“Provided further that in cases, where the registration had been made prior to the date
of commencement of the Tamil Nadu Registration of Births and Deaths Rules, 2000 and the
information regarding the name of the child is not given within the time-limit specified in the
first proviso, for the purpose of taking action as laid down therein, the parent or guardian of the
child shall give the information regarding the name of the child to the Registrar within a further
period of five years.”]

1. This proviso was added vide G.O.(Ms.) No.252 Health and Family Welfare(AB2) Department,
dt 18.10.2016.

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 the Registrar shall:

(a) if the register is in his possession forthwith enter the name in the relevant
column of the concerned form in the birth register on payment of a late fee of 1[rupees two
hundred]

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 in the case of the local authorities specified in column (1) of the Table below to the
officers specified in the corresponding entries in column (2) thereof for making necessary
entry on payment of a late fee of 2[rupees two hundred]

TABLE

Local Authorities Officers

(1) (2)

Village Panchayat Village Panchayat President

Town Panchayat Executive Officer
Contonment -Do-
Municipality Commissioner
Neyveli Lignite Corporation Chief Health Officer
Corporation Commissioner

(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 3[ first proviso] to
sub-rule (1)

1. These words were substituted for the words “rupees five”

2. These words were substituted for the words “rupees five”
vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.2017.
3. This expression was substituted for the expression “Provision”
vide G.O.(Ms.) No.252 Health and Family Welfare(AB2) Department, dt 18.10.2016.

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11. Correction or cancellation of entry in the register of births and deaths under section 15

(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 canceling the entry) as provided in section 15 and
shall in the case of local authorities specified in column (1) of the Table below send an extract
of the entry showing the error and how it has been corrected to the officer specified in column
(2) thereof.

TABLE

Local Authorities Officers

(1) (2)
Village Panchayat Village Panchayat President
Town Panchayat Executive Officer
Contonment -Do-
Municipality Commissioner
Neyveli Lignite Corporation Chief Health Officer
Corporation Commissioner

(2) In the case referred to in the sub-rule (1) if the register is not in his possession, the
Registrar shall make a report to the officer specified in the table in sub-rule (1) and call for the
relevant register and after enquiring into the matter, if he is satisfied that such error has been
made, necessary correction.

(3) Any such correction as mentioned in sub-rule (2) shall be countersigned by the officer
specified in the Table in sub-rule (1) 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 in the manner prescribed under 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.

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 (5) Not withstanding anything contained in sub-rules (1) and (4), the Registrar shall make a
report of any correction of the kind referred to therein giving necessary details to the officer
specified in the table in sub-rule (1).

(6) If it is proved to the satisfaction of the Registrar that any entry in the register of births and
deaths has been fraudulently or improperly made, he shall make a report giving necessary
details to the officer authorized by the Chief Registrar by general or special 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.

12. Form of register under section 16 :– 1[(1) The legal part of the [Form Nos. 1, 2 and 3
shall be the Form No. 7, 8 and 9 and shall constitute the birth register, death register and still
birth register respectively.]

(2) From 1st January of each calendar year new registration number starting from 1
should be followed and continues till 31st December of that year.

(3) An event which occurred in any previous year reported during the current year
shall be recorded in the current year register only.

(4) A control register in 2[Form No.14A] shall be maintained by the Tahsildar to

watch receipt of returns from all registration units in the area and dispatch of the same to the
Chief Registrar or to the officer specified by him in this behalf.

1. These words were substituted for the words

“The Legal Part of Form 2, 3 and 4 shall be Form 8,9 and 10 and shall constitute the Birth
Register, Death Register and Still Birth Register respectively.
2. The expression was substituted for the expression ‘Form 15’
vide G.O.Ms.No.85 Health& Family Welfare (AB2) Department, dated.29.04.2003

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 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 –
Rs.
1
[(a) Search for a single entry in the first year for which the search is made 100/-
(b) For every additional year for which the search is continued 100/-
(c) For granting extract relating to each birth or death 200/-
(d) For every additional copies of extract 200/-
(e) For granting non-availability certificate 100/-]
Provided that no fee shall be payable by any officer of the Government of Tamil Nadu
or by any member of the staff of Estate duty circles duly authorized by their officers or by
any person duly authorized by the District Soldiers, Sailors and Airmen’s Board for searching
or for obtaining an extract or for giving non-availability certificate of birth or death from any
registrar for a bonafide public purpose, including the investigation of pension claims from
families of deceased Indian Military Personnel.
(2) Any such extract in regard to a birth or death shall be issued in 2[Form No.5 or in
Form No.6] as the case may be and shall be certified in the manner provided for in section 76
of the Indian Evidence Act, 1872, (Act 1 of 1872), in the case of local authorities specified in
column (1) of the table below by the Registrar or the Officers specified in the corresponding
entries in column (2) thereof:
TABLE
Local Authorities (1) Officers (2)
Village Panchayat Village Panchayat President and Executive Officer (till
the expiry of two years after the close of the calendar year to
Town Panchayat which the register relates).
Sub-Registrar of Assurance (after the expiry of two years).
Contonment Executive Officer
Municipality Commissioner
Corporation -Do-
Neyveli Lignite Corporation Chief Health Officer
(3) If any particular event of birth or death is not found registered, the Registrar or the
officers specified in column 2 of the Table under sub-rule 2 shall issue a non-availability
certificate in 3[Form No.10].
(4) Any such extracts or non-availability certificate may be furnished to the person
asking for it or sent to him by post on payment of the postal charges there for.
1.The expression were substituted for the expression
(a) search for a single entry in the first year for which the search is made Rs.2.00/-
(b)for every additional year for which the search continued Rs.2.00/- (c) for granting extract relating to
each birth or death Rs.5.00/-
(d) for granting non-availability certificate of birth or death Rs.2.00/-
vide G.O.Ms.No.360Health&FamilyWelfare (AB2) Department, dated.12.10.2017
2. The expression was substituted for the expression
“Form No.6 or in Form No.7”
3. The expression was substituted for the expression
“Form No.11”
vide G.O.Ms.No.85 Health& Family Welfare (AB2)Dept, dated.29.04.2003.

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 14. Interval and forms of periodical returns under sub-section (1) of section 19 :–
1
[(1) Every Registrar shall after completing the process of registration send all the statistical
parts of the reporting forms relating to each month along with a summary monthly report in
Form No.11 for Birth, Form No.12 for deaths, and Form No.13 for Still Births to the
th
Chief Registrar or the officer specified by him in this behalf on or before the 5 of the
following month].

(2) The officer so specified shall forward all such statistical parts of the reporting forms
received by him to the Chief Registrar or the officer specified by him, not later than 10th of that
month.

15. Statistical report under sub-section (2) of 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 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 late that five months from
that date].

16. Conditions for compounding offences under section 23 :– (1) Any offence punishable
under section 23 may, either before or after the institution of criminal proceeding under this
Act, be compounded by an officer authorized by the Chief Registrar by a general or special
order in this behalf, if the officer so authorized 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-sections (1), (2) and (3) and rupees ten for offences under
sub-section (4) of section 23 as the said officer may think fit.

1. These words were substituted for the words

“Every Registrar shall after completing the process of registration send all the statistical part of the
reporting forms relating to each month along with a summary monthly report in form 12, 13 and 14 to
the Chief Registrar or the office specified by him in their behalf on or before the 5th of the following
month.
2. These words were substituted for the words
The statistical report under Sub-section (2) of section 19 shall be in Form 16 and shall be compiled for
each year before the 31st July of the year immediately following shall be published as a Government
publication in the form of a booklet as soon as may be thereafter but in any case not later than five
months from that date.
vide G.O.Ms.No.85 Health& Family Welfare (AB2)Department, dated.29.04.2003

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17. Registers and other records under section 30 (2) (k):- (1) The birth register, death
register and still birth register shall be records of permanent importance and shall not be
destroyed.

(2) 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 register 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 this 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 such register shall thereafter in the case of the local authorities specified in the
column (1) of the Table below be transferred for safe custody to the officers specified in the
corresponding entries in column (2) thereof.

TABLE

Local Authorities Officers

(1) (2)
Village Panchayat Village Panchayat President and
Executive Officer (till the expiry of two years
Town Panchayat after the close of the calendar year to which the
register relates).
Sub-Registrar of Assurance (after the
expiry of two years).
Contonment Executive Officer
Municipality Commissioner
Corporation -Do-
Neyveli Lignite Corporation Chief Health Officer

18. Manner of payment of fees:- All fees payable under the Act may be paid in cash or
money order or postal order.

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 ANNEXURE

(See Rule 4)
REPORT ON THE WORKING OF THE ACT

1. Brief description of 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 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.
(i) Administrative.
(ii) Others.
14. Orders and Instruction issued under the Act.
15. General remarks.

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 FORM NO. 1
Form No.1 Birth Report (See Rule 5) In the case of multiple births, fill in a separate
Legal Information BIRTH REPORT FORM form for each child and write ‘Twin birth’ or
This part to be added to the Birth Register Statistical Information ‘Triple birth’ etc., as the case may be, in the
This part to be detached and sent for statistical processing remarks column in the box below left
To be filled by the informant To be filled by the informant To be filled by the informant
1. Date of Birth: ____________________________ 10. Town or Village of Residence of the mother:
(Enter the exact day, month (Place where the mother usually lives. This can be 16. Age of the mother (in completed years)
and year the child was born e.g.1-1-2000) different from the place where the delivery occurred. at the time of marriage: ____________
The house address is not required to be entered.) (If married more than once, age at first
2. Sex : ___________________
marriage may be entered)
(Male/Female/Transgender) a) Name of the Town / Village: ______________________
do not use abbreviation) 17. Age of the mother (in completed years)
b) Is it a town or village: (Tick the appropriate entry at the time of this birth :
3. Name of the child, if any: ______________________
below)
(If not named, leave blank) 18. Number of children born alive to the
4. Name of the father : __________________________ 1. Town 2. Village
mother so far including this child :
(Full name as usually written) c) Name of District: ________________________________ (Number of children born alive to
UID No of Father (if any) include also those from earlier
d) Name of State: ________________________________
marriage(s), if any)
5. Name of the Mother: _________________________ 11. Religion of the Family : (Tick the appropriate entry 19. Type of attention at delivery : (Tick the
(Full name as usually written) below)
UID No of mother (if any) appropriate entry below)
1. Hindu 2. Muslim 3. Christian
1.Institutional – Government
4. Any other religion: (Write the name of the
6. Address of parents at the religion) 2.Institutional – Private or Non-
time of Birth of the Child __________________________ Government
__________________________________________________ 12. Father’s level of education : ______________________ 3.Doctor, Nurse or Trained midwife
(Enter the completed level of education e.g. if 4.Traditional Birth Attendant
7. Permanent address of parents : ____________________ studied upto class VII but passed only class VI,
____________________________________________________ 5.Relatives or others
write class VI)
8. Place of Birth : _____________________
(Tick the appropriate entry 1 or 2 below and give 13. Mother’s level of education : ______________________ 20. Method of Delivery : (Tick the
the name of the Hospital/Institution or the address of (Enter the completed level of education e.g. if appropriate entry below)
the house where the birth took place) studied upto class VII but passed only class VI, 1. Natural
write class VI) 2. Caesarean
1. Hospital / Institution Name & ___________________
Address ________________________________________ 3. Forceps/Vaccum
14. Father’s Occupation: ____________________________
2. House Address: ________________________________ 21. Birth Weight (in kgs.) (if available) :
(If no occupation write ‘Nil’)
3. Others ________________________________
9. Informant’s name: ________________________________ 15. Mother’s Occupation: ____________________________ 22. Duration of pregnancy (in weeks) :
Address: ________________________________ (If no occupation write ‘Nil’)
(After completing all columns 1 to 22, informant will put (Columns to be filled are over. Now put
date and signature here:) signature at left)
Date: Signature or
left thumb mark of the informant
To be filled by the Registrar To be filled by the Registrar To be filled by the Registrar
Registration No: Registration Date: Name Code No. Registration No: Registration Date:
Registration Unit: District: District: Date of Birth:
Town/Village: Taluk: Sex: 1. Male 2. Female 3. Transgender
Remarks: (If any) Town/Village: Place of Birth: 1.Hospital/Institution 2. House
Registration Unit:
Name and Signature of the Registrar Name and Signature of the Registrar

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 FORM NO. 2 (See Rule 5)
Form No.2 Death Report Form No.2 Form No.2
Legal Information This part to be detached and sent for statistical processing
This part to be added to the Death Register Death Report
(Statistical Information)
To be filled by the informant To be filled by the informant To be filled by the informant
1. Date of Death: ___________________________
(Enter the exact day, month 11. Town of Village of Residence of the deceased: 15. Was the cause of death medically certified?
and year the death took place) (e.g.1.1.2000) (Place where the deceased actually lived. This can be (Tick the appropriate entry below)
2. Name of the Deceased: _______________________ different from the place where the death occurred. The 1. Yes 2. No
(Full name as usually written) house address is not required to be entered.)
UID No of deceased (if any) 16. Name of Decease or Actual Cause of Death:
a) Name of Town / Village: (for all deaths irrespective of whether
3. Sex of the deceased: _________________________ b) Is it a town or village: medically certified or not)
Male/Female/Transgender (Tick the appropriate entry below)
(do not use abbreviation) 2. Town 2. Village 17. In case this is a female death, did the death
4. Name of the Mother: _______________________________ c) Name of District: occur while pregnant, at the time of delivery
UID No of mother (if any) d) Name of State: or within 6 weeks after the end of pregnancy:
(Tick the appropriate entry below)
5. Name of the Father: _________________________________ 12. Religion: (Tick the appropriate entry below)
UID No of Father (if any) 1. Yes 2. No.
2. Hindu 2. Muslim 3. Christian
18. If used to habitually smoke –
5.a. Name of Husband/Wife: ______________________________
4. Any other religion: (Write the name of the religion) for how many years?
UID No of Husband/Wife (if any)
13. Occupation of the deceased: 19. If used to habitually chew tobacco in any
6. Age of the deceased: __________________________________ (If no occupation write ‘Nil’) form –
(If the deceased was over 1 year of age, give age in completed years. For how many years?
If the deceased was below 1 year of age, give age in months, and if 14. Type of medical attention received before death:
below 1 month give age in completed number of days, and if below (Tick the appropriate entry below) 20. If used to habitually chew arecanut in any
one day, in hours) form (including pan masala)-
7. Address of the deceased at the time of death:_____________ 1. Institutional for how many years?
________________________________________________________
2. Medical attention other than institution
8. Permanent address of the deceased: _____________________ 21. If used to habitually drink alcohol-
________________________________________________________ 3. No Medical attention for how many years?
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:___________________
& Address : ___________________________________
2. House Address: ______________________________
3. Other place __________________________________
10. Informant’s name: _____________________________________
Address: _______________________________________________
(After completing all columns 1 to 21, informant will put date (Column to be filled are over, Now put signature
and signature here:) at left)
Date: Signature or left thumb mark of the informant
To be filled by the Registrar To be filled by the Registrar Registration No: Registration Date:
Registration No: Registration Date: Name Code No. Date of Death:
Registration Unit: District: District: Age: Years/months/days/hours
Town/Village: Taluk: Sex: 1. Male 2. Female 3.Transgender
Remarks: (If any) Town/Village: Place of Death: 1. Hospital/Institution
Name and Signature of the Registrar Registration Unit: 2. House 3.Other place
Name and Signature of the Registrar

16
 FORM NO. 3
Form No.3 FORM NO. 3 FORM NO. 3
Still Birth Report STILL BIRTH REPORT FORM (See Rule 5)
Legal Information Statistical Information
This part to be added to the Still Birth Register This part to be detached and sent for statistical processing. In the case of
multiple births, fill in a separate form for each child and write ‘Twin birth’
etc, as the case may be, in the remarks column in the box below left.
To be filled by the informant To be filled by the informant
1. Date of Birth: ________________________________
(Enter the exact day, month 7. Town or Village of Residence of the mother:
and year) (e.g.01-01-2000) (Place where the mother usually lives. This can be different from the place where the delivery
2. Sex : ____________________ occurred. The house address is not required to be entered.)
Male/Female/Transgender) a) Name of Town / Village:
do not use abbreviation)
b) Is it a town or village: (Tick the appropriate entry below)
3. Name of the father : ________________________ 1. Town 2. Village
(Full name as usually written)
UID No of father (if any) c) Name of District:
d) Name of State:
4. Name of the mother: __________________________
(Full name as usually written) 8. Age of the mother (In completed years)
UID No of Mother (if any) at the time of this birth :

9. Mother’s level of education :

5. Place of Birth : (Tick the appropriate entry below and (Enter the completed level of education e.g. if studied upto class VII but passed only class VI, write
give the name of the Hospital/Institution or the class VI)
address of the house where the birth took place)
1. Hospital / Institution Name &_________________ 10. Type of attention at delivery : (Tick the appropriate entry below)
Address: ______________________________________
2. House Address: _______________________________ 1. Institutional – Government
2. Institutional – Private or Non- Government
5.a. Permanent address of parents : __________________
3. Doctor, Nurse or Trained midwife
__________________________________________________
4. Traditional Birth Attendant
5.b. Address of parents at the
time of Still Birth of the Child _____________________ 5. Relatives or others
__________________________________________________ 11. Duration of pregnancy : (in weeks)
6. Informant’s name: _______________________________ 12. Cause of foetal death : (if known)
Address: ________________________________________
(After completing all columns 1 to 12, informant will put
date and signature here:) (Columns to be filled are over. Now put signature at left)

Date: Signature or left thumb mark of the informant

To be filled by the Registrar To be filled by the Registrar
Registration No: Registration Date: Registration No: Registration Date:
Registration Unit: District: Name Code No. Date of Birth:
Town/Village: District: Sex: 1. Male 2. Female 3. Transgender
Remarks: (If any) Taluk: Place of Birth:1.Hospital/Institution 2.House
Town/Village:
Name and Signature of the Registrar Registration Unit: Name and Signature of the Registrar

17
 Form No.1A
(See Rule 5)
Form No. 1-A Form No.1-A
Birth Report for Adopted Child Birth Report for Adopted Child
Legal Information Statistical Information
(This part to be added to the Birth Register) (This part to detached and sent for statistical processing)
To be filled by the informant To be filled by the informant
1*. Date of Birth: _____________________________
(if known, write exact date of birth)
14. Religion of the adoptive Father: (Tick the appropriate entry below)
(Otherwise record the date of birth as ascertained by the Magistrate)
1. Hindu 2. Muslim 3. Christian
2*. Sex : ___________________________
(Enter “Male or Female)
15. Adoptive Father’s level of education:
Do not use abbreviation
(Enter the completed level of education
3. Name of the Child: _______________________________
e.g. if studied upto class VII but passed
(If name is changed on adoption, write new name)
only class VI, write class VI)
4*. Name of the Mother:(If known) _______________________
UID Number of Mother (if any)
16. Adoptive Mother’s level of education:
5*. Name of the Father:(If known) ________________________ (Enter the completed level of education
UID Number of Father(if any) e.g. if studied upto class VII but passed only class
VI, write class VI)
6. Date and number of adoption deed / order: ___________________
7. Name of the adoptive mother:
UID Number of adoptive mother(if any)
17. Adoptive father’s occupation
8. Name of the adoptive father: (if no occupation write ‘Nil’)
UID Number of adoptive father (if any)

9. Address of adoptive parents as recorded in Adoption deed: 18. Adoptive mother’s occupation:
__________________________________________________________________ (If no occupation write ‘Nil’)
10. Permanent address of adoptive parents : _________________________
_________________________________________________________________
11*. Place of birth ___________________________________________________
12. If adoption through agency write the place and address
Of the Adoption agency __________________________________________
13. Informant’s name and address: __________________________________
__________________________________ (Columns to be filled are over, Now put signature at left)
(After completing all columns 1 to 18 informant will put date and
signature here)
*As contained in the original birth certificate.
Date Signature or left thumb mark of the informant
To be filled by the Registrar To be filled by the Registrar
Registration No: Registration Date: Name Registration No. Registration Date:
Registration Unit District: Date of Birth
Town/ Village District: Taluk:
Remarks:(If any) Town/ Village : Sex:1. Male 2. Female
Registration Unit: Place of Birth:
Name and Signature of the Registrar Code No: Name and Signature of the Registrar
18
 FORM NO.4
(See Rule 7)
MEDICAL CERTIFICATE OF CAUSE OF DEATH
(Hospital in patients. Not to be used for stillbirths)
To be sent to Registrar along with From 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
Age at Death Statistical
If 1 year or If less than 1 If less than one If less than one Office
Sex
more, age in year, age in month, age in days day, age in Hours
years Months
1. Male
2. Female
CAUSE OF DEATH Interval between
onset & death
Approx
I. Immediate cause
……………………..
State the disease, injury or complication
which Caused death, not the mode of dying (a) …………………
………………
such as Hear failure, asthenia, etc. due to (or as
consequences of)
Antecedent cause ……………………..
Morbid conditions, if any, giving rise to the
above Cause, stating underlying conditions (b)………………….
last due to (or as ………………
consequencesof) ……………………..
(c).......................... ………………
II.
……………………..
Other Significant conditions contributing to the
Death but not related to the diseases or conditions …………………….. ……………..
..............................
causing it.
..............................
……………..
Manner of Death
1. Natural 2. Acident 3. Suicide 4. Homicide How did they injury occur?
5. Pending Investigation
If deceased was a female, was pregnancy the death 1. Yes 2. No
associated with?
If yes, was there a delivery? 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)
19
 MEDICAL CERTIFICATE OF CAUSE OF DEATH
Directions for completing the form
Name of deceased: To be give 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 Deaths: 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, 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 be 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 in 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 rise 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 question 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.
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. Neoplasm – Indicate whether benign or malignant,
and site, with site of primary neoplasm, whenever possible, Hear 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, diarrhea, 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.

20
 FORM NO.4A
(See Rule 7)
MEDICAL CERTIFICATE OF CAUSE OF DEATH
(For Non-Institutional deaths. Not to be used for stillbirths)
To be sent to Registrar along with From 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

Age at Death Statistical
Age in completed If less than 1 If less than one If less than one Office
Sex
years year, age in month, age in day, age in Hours
Months days
3. Male
4. Female
CAUSE OF DEATH Interval between
onset & death
Approx
I. Immediate cause
……………………..
State the disease, injury or complication
which Caused death, not the mode of dying (a) …………………
due to (or as ………………
such as Heart failure, asthenia, etc.
consequences of)
Antecedent cause ……………………..
Morbid conditions, if any, giving rise to the (b)………………….
above Cause, stating underlying conditions due to (or as ………………
last consequences of) ……………………..
………………
II. (c)........................
……………………..
Other Significant conditions contributing to the
Death but not related to the diseases or conditions ........................... …………………….. ……………..
causing it. ...........................
……………..
If deceased was a female, was pregnancy the death
associated with? 1. Yes 2. No
If yes, was there a delivery? 1. Yes 2. No

Name and Signature of the Medical Practitioner 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 under my treatment from…………….to…………….and he/she
expired on ……………at ………………A.M./P.M.

Doctor:…………………………………..
(Signature and address of Medical
Practitioner/Medical attendant with
Registration No.)

21
 MEDICAL CERTIFICATE OF CAUSE OF DEATH
Directions for completing the form
Name of deceased: To be give 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 Deaths: 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, 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 be 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 in 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 rise 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 question 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.
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. Neoplasm – Indicate whether benign or malignant,
and site, with site of primary neoplasm, whenever possible, Hear 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, diarrhea, 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.

22
 Government of Tamil Nadu
jäœehL muR
Form No.5 got« v©.5
Department of ______________________________
-------------------- Jiw
BIRTH CERTIFICATE – Ãw¥ò rh‹¿jœ
(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 and
Rule 8/13 of the Tamil Nadu Registration of Births and Deaths Rules, 2000)

This is to certify that the following information has been taken from the original record
of Birth which is the register for (local area / local body) ------------ of Taluk ------------
of District -------------------------------- of State TAMIL NADU.
Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------
t£l« ------------- nr®ªj mrš Ãw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœ
tH§f¥gL»wJ.
Name/ bga® : _______________________ Sex / ghèd«: ________________
(M©/bg©/ÂUe§if)
Date of Birth / Ãwªj nj : ____________________________
Place of Birth / Ãwªj Ïl« : ____________________________
Name of the Mother / jhæ‹ bga® : ____________________________
UID Number of Mother / jhæ‹ Mjh® v© : ____________________________
Name of the Father / jªijæ‹ bga® : ____________________________
UID Number of Father/ jªijæ‹ Mjh® v© : ____________________________
Address of the parents at the time
of birth of the child/ Permanent address of the parents/
FHªij Ãw¥Ã‹ nghJ bg‰nwhç‹ Kftç bg‰nwhç‹ ãiyahd Kftç
------------------------------ ------------------------
------------------------------ ------------------------
Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------
Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________
Date of Issue / tH§»a ehŸ : ____________________________
Address of the Issuing Authority Signature of Issuing Authority
rh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«
Seal / K¤Âiu

“Ensure registration of every birth and death”

“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

23
 Government of Tamil Nadu
jäœehL muR
Form No.6 got« v©.6
Department of ______________________________
-------------------- Jiw
DEATH CERTIFICATE – Ïw¥ò rh‹¿jœ
(Issued under section 12/17 of the Registration of Births and Deaths Act 1969 and
Rule 8/13 of Tamil Nadu Registration of Births and Deaths Rules, 2000)

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 Taluk ------------
of District -------------------------------- of State TAMIL NADU.
Ñœ¡f©l jftšfŸ jäœehL khãy« -------------------- kht£l« --------------
t£l« ------------- nr®ªj mrš Ïw¥ò¥ gÂnt£oèUªJ vL¡f¥g£lit vd rh‹¿jœ
tH§f¥gL»wJ.
Name/ bga® : ----------------------- Sex / ghèd«: ________________
(M©/bg©/ÂUe§if)
UID Number of deceased / Ïwªjtç‹ Mjh® v©: ____________________________
Date of Death / Ïwªj nj : ____________________________ Age / taJ : ________________
Place of Death / Ïwªj Ïl« : ____________________________
Name of the Mother / jhæ‹ bga® : ____________________________
UID Number of Mother / jhæ‹ Mjh® v© : ____________________________
Name of the Father / jªijæ‹ bga® : ____________________________
UID Number of Father / jªijæ‹ Mjh® v© : ____________________________
Name of the Husband / Wife fzt® / kidéæ‹ bga® : ____________________________
UID Number of Husband / Wife / fzt® / kidéæ‹ Mjh® v© : ____________________
Address of the deceased at the time of death/ Permanent address of the deceased/
Ïw¥Ã‹nghJ Ïwªjtç‹ Kftç Ïwªjtç‹ ãiyahd Kftç
------------------------------ ------------------------
------------------------------ ------------------------
Registration No/ gÂÎ v©: __________ Date of Registration / gÂÎ brŒj njÂ/---------
Remarks (If any) / F¿¥òiu (VnjDäU¥Ã‹) : ____________________________
Date of Issue / tH§»a ehŸ : ____________________________
Address of the Issuing Authority Signature of Issuing Authority
rh‹¿jœ më¥gtç‹ Kftç rh‹¿jœ më¥gtç‹ ifbah¥g«
Seal / K¤Âiu
“Ensure registration of every birth and death”
“X›bthU Ãw¥ò k‰W« Ïw¥ig gÂÎ brŒtij cWÂbrŒÅ®”

24
 FORM No.7
(See Rule 12)
BIRTH REGISTER
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 : ___________________
(Male/Female/Transgender)
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)
UID No of Father (if any)

5. Name of the Mother: _________________________

(Full name as usually written)
UID No of mother (if any)

6. Address of parents at the

time of Birth of the Child __________________________
__________________________________________________

7. Permanent address of parents : ____________________

____________________________________________________
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)

5. Hospital / Institution Name & ___________________

Address ________________________________________
6. House Address: ________________________________
7. Others ________________________________
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: District:
Town/Village:
Remarks: (If any)

Name and Signature of the Registrar

25
 FORM No.8
(See Rule 12)
DEATH REGISTER
DEATH REPORT
Legal Information
This part to be added to the Birth 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)
UID No of deceased (if any)

3. Sex of the deceased: _________________________

Male/Female/Transgender (do not use abbreviation)
4. Name of the Mother: _______________________________
UID No of mother (if any)

5. Name of the Father: _________________________________

UID No of Father (if any)

5.a. Name of Husband/Wife: ______________________________

UID No of Husband/Wife (if any)

6. 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)
7. Address of the deceased at the time of death:_____________
________________________________________________________
8. Permanent address of the deceased: _____________________
________________________________________________________
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)
8. Hospital / Institution Name:___________________
& Address : ___________________________________
9. House Address: ______________________________
10. Other place __________________________________
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: District:
Town/Village:
Remarks: (If any)

Name and Signature of the Registrar

26
 FORM No.9
(See Rule 12)
STILL BIRTH REGISTER
STILL 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) (e.g.01-01-2000)
2. Sex : ____________________
Male/Female/Transgender)
do not use abbreviation)

3. Name of the father : ________________________

(Full name as usually written)
UID No of father (if any)

4. Name of the mother: __________________________

(Full name as usually written)
UID No of Mother (if any)

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 & ___________________

Address: ______________________________________

2. House Address: _______________________________

5.a. Permanent address of parents : __________________

__________________________________________________
5.b. Address of parents at the
time of Still Birth of the Child _____________________
__________________________________________________

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 informant

To be filled by the Registrar

Registration No: Registration Date:

Registration Unit: District:
Town/Village:
Remarks: (If any)
Name and Signature of the Registrar

27
 Form 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

years(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.

Signature of Registrar

Date: ………………………………….. Signature of issuing authority

Date
Seal

28
 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 be equal to the number of statistical part of Birth Report Forms (Form No.1)
attached with this monthly report.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar / Additional District Registrar

29
 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 Maternal
Registered within one year of Registered after one year of Total*
Deaths Deaths
occurrence occurrence
1. 2. 3. 4. 5.

Note: Infant and Maternal Deaths should also be included in the Deaths.

*Total should be equal to the number of statistical part of Death Report Forms (Form No.2)
attached with this monthly report.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar /Additional District Registrar

30
 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 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.

Dated: Signature and name of the Registrar

Submitted to the chief Registrar / Additional District Registrar

31
 Name of
Panchayats/Village/
Town
Date of Receipt

Date of Despatch

January
Date of Receipt

Date of Despatch

February
Date of Receipt
Name of Taluk/Panchayat Union:

March
Date of Despatch

Date of Receipt
April

Date of Despatch

Date of Receipt
May

Date of Despatch

Date of Receipt
June

Date of Despatch

Date of Receipt
(PART A)
Form No.14-A

July

Date of Despatch
[See Under Rule (12)]

Date of Receipt
[Under Rule 12(4) Under Sec 16]

Date of Despatch
August

Date of Receipt
CONTROL REGISTER FOR THE YEAR………………………….

Date of Despatch
September

Date of Receipt

Date of Despatch
October

Date of Receipt

Date of Despatch
November

32

Date of Receipt

Date of Despatch
December
 Form No.14-B
[See Rule 4 and 15]
FORM NO.14 - B AS IN THE EXISTING RULES
(PART B)

Name of Taluk/Panchayat Union:

Panchayats/Village/
Name of

Town

January February March April May June July August September October November December
Death

Death

Death

Death

Death

Death

Death

Death

Death

Death

Death

Death
Birth

Birth

Birth

Birth

Birth

Birth

Birth

Birth

Birth

Birth

Birth

Birth
33