Pre & Post Natal Care and Birth Registration  

•  Pre & Post natal care is an important issue to reduce mortality rate of new born babies and also to ensure safe and healthy motherhood. Creation of a data bank for birth and to link this with Pre & post natal care program will help Govt to plan support system for expectant mothers and new born babies. Birth registration forms an important aspect of planning support system for children and mother also. It is imperative that registration of pregnancy and birth is made a simple and digitized procedure to ensure that every pregnancy and child birth is registered. In order to create awareness and ensure compliance Govt must make it mandatory to produce birth certificate for any Govt sponsored benefits including issue of aadhaar card and school admission. 

•  There is a need to change application form for birth registration to ensure uniformity and inclusion of all relevant details to enable govt to work out and create infrastructure for child & mother care support system. 

•   Format of application for registration of pregnancy and birth is give below.

APPLICATION FORM FOR REGISTRATION OF PREGNANCY AND BIRTH

(Mandatory to Register for Pregnancy after Four Weeks for Natal Care & Issue for Birth Certificate)

(All fields are mandatory)

 

PARTICULARS OF APPLICANT
1	Name of Applicant			Aadhaar No
2	Mobile No			H NO
3	Locality			Area
4	Police Station			Post office
5	City			Tehsil
6	Distt			PIN
7	Place of Birth			Distt
PARTICULARS OF PARENTS
8	Father’ Name			Aadhaar No
9	Occupation
10	Date of Birth			Age		Years
11	Place of Birth			Distt
12	Mobile No			Blood Group
13	House No			Colony
14	Town			Tehsil
15	Distt			PIN
16	Mother’s Name			Aadhaar No
17	Occupation			Age		Years
18	Place of Birth			Distt
19	Mobile No			Blood Group
PARTICULARS OF HOSPITAL/CHC/PHC WHERE PREGNANCY WAS REGISTERED
20	Name of Hospital			Regn No
21	Postal Address
22	City			Distt
23	State			PIN
24	Dt of Regn of Pregnancy			Pregnancy Period on dt of Regn		Weeks
25	Name of Attending Dr / Nursing Staff			Regn No (Dr)
26	Pregnancy Regn No
27	Details of Living Children (Add rows in case of more than four children)
28	Name of Child		Sex	DOB		Age (Years)
(a)
(b)
(c)
(d)
BIRTH DETAILS
29	Name of Child			DOB
30	Sex		Male/ Female	Religion
31	Hospital			Regn NO
32	Ward			Zone
33	City			Tehsil
34	Police Station			Post Office
35	Distt			PIN
36	Blood Group			Birthmark, if any
37	Attending Dr/Nurse			Regn No
38	Procedure of Delivery			Weight of Child
39	Mother’s Age at Marriage			Mother’s Age & Weight at Delivery
COPIES OF DOCUMENTS/CERTIFICATES ATTACHED
40		Documents (Any three documents out of documents listed from (a) to (g) to be attached)
(a)		Aadhaar Card		Attached/Not attached
(b)		PAN Card		Attached/Not attached
(c)		Voter ID		Attached/Not attached
(d)		Ration Card		Attached/Not attached
(e)		Driving License		Attached/Not attached
(f)		Passport		Attached/Not attached
(g)		Affidavit		Attached/Not attached
(h)		Serving Certificate by Dept if Father/Mother is a Govt Servant (Mandatory)		Attached/Not attached
(j)		Serving Certificate by Office if Father/Mother is working in PSU/Private Sector (Mandatory)		Attached/Not attached
DECLARATION BY APPLICANT/PARENTS
41		I hereby solemnly declare that all the statement made in the above application are true and correct to be best of my knowledge and belief.
42		Place		Signature
43		Date
44		Witness’ Name		Signature
FOR OFFICE USE ONLY
45		Dt of Receipt of Application		Regn No
46		Fee (Rs 10 Only)		UPI ID
47		Birth Certificate No		Dt of Issue
48		Issuing Authority		Signature
49		Digital Record Filed		Digital ID

Note: Regn of birth is mandatory. Birth Certificate is mandatory for issue of Aadhaar Card and admission in any Educational Institution.