SARAL Print

State

Hospital *

Government Name *

सरकार का नाम *

Top Left No. in Local Language *

Top Right No. in Local Language *

Department Name *

विभाग का नाम *

Hospital Name *

अस्पताल का नाम *

Birth Certificate in Local Language - जन्म प्रमाण पत्र - स्थानीय भाषा मे *

लाइन नंबर 1 *

Line no. 1 *

लाइन नंबर 2 *

Line no. 2 *

Name in Local Language *

Gender in Local Language *

Date Of Birth in Local Language *

Place Of Birth in Local Language *

Mother Name in Local Language *

Father Name in Local Language *

ADDRESS OF PARENTS AT THE TIME OF BIRTH OF THE CHILD [ Local Language ] *

PERMANENT ADDRESS OF PARENTS *

REGISTRATION NUMBER in Local Language *

DATE OF REGISTRATION in Local Language *

Remarks in Local Language *

DATE OF Issue in Local Language *

ISSUING AUTHORITY in Local Language *

Registrar in Local Language *

Registrar *

Hospital Stamp in Local Language *

Hospital Name as on Stamp *

Aadhar Number in Local Language *

Last Line in Local Language *

State Logo *

Form Logo *

Add Signature *

Add Stamp

Apply for Birth Hospital