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Nagar Palika
Chair Person
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EO
Mubarakpur
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Online Application for Birth
Legal Information
Date of birth:
Child Name:
Father Name:
Sex:
------Select Sex-----
Male
Female
Mother Name:
Birth Place
Hospital
Home
Other
Indicator Name:
Application Date:
Indicator Address:
Statistical Information
Father/Mother's Address:
Address at the time of child birth:
Religion:
------Select Religion-----
Hindu
Muslim
Father's Qualification:
Father's Profession:
Mother's age at marriage time:
Permanent Address:
Mother's Qualification:
Mother's Profession:
Mother's age at delivery time:
Total living child generated by Mother :
At Delivery Time:
Type of care:
Traditional Midwife
Doctor
Relatives
Other
Delivery Method:
Natural
Other
Weight of child at time of birth:
Duration of pregnancy:
Messages :
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Nagar Palika Parishad Mubarakpur