Addition of Name of Child in Birth Certificate

7/26/2019 Addition of Name of Child in Birth Certificate

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Addition of Name of Child in Birth Certificate/ ਜਨਮ ਦਰਜ

ਲ

1. Residence Certificate Type /

2. Name of the child to be added / ਦਰਜ

3. Late Reason /

4. Grandfather's Name /

5. Address of Parents at the time of Birth /

Original Birth Certificate Data / ਜਨਮ

1. Birth Certificate No. / ਜਨਮ

2. Birth Certificate Issuance Date / ਜਨਮ

3. Place of birth / ਜਨਮ

Registration Details /

1. Registration Office / ਦਫਤਰ

2. Registration No. /

3. Date of Registration /

4. District /

5. Tehsil /

6. Police Station /

--Select--/ਚਣ ਕਰ

2783

--Select--/ ਚਣ ਕਰ

--Select--/ ਚਣ ਕਰ

-- e ect--/ ਚਣ ਕਰ



Page 3 of 7

Information Corrected by Dealing Clerk / Computer Clerk (EOMC)/

ਲਰ ਲਰ ਗ

1. Police Station /

2. Date of birth / ਜਨਮ

3. Verification Record ID /

4. Citizen First Name in Punjabi /

5. Citizen Middle Name in Punjabi /

6. Citizen Last Name in Punjabi /

7. Father's First Name in Punjabi /

8. Father's Middle Name in Punjabi /

9. Father's Last Name in Punjabi /

10. Mother's First Name in Punjabi /

11.

Mother's Middle Name in Punjabi /

12. Mother's Last Name in Punjabi /

Part – 2 Personal Details /

Personal Data /Fill in English

1. Salutation / Mr. / Mrs. / Ms./

2. Citizen First Name /

3. Citizen Middle Name /

4. Citizen Last Name /

5. Gender / Male/ Female/

6. Date of birth /

7. Father's First Name /

8. Father's Middle Name /

9. Father's Last Name /

10. Mother's First Name /

11. Mother's Middle Name /

12. Mother's Last Name /

13. Place of Birth /

-- e ect--/ ਚਣ ਕਰ



Page 4 of 7

14. Marital Status /

15. Spouse Name /

16. Email ID /

17. Phone Number /

18. Mobile Number /

Permanent Address /

1. Address is Out of state? /

?

2. State /

3. District /

4. Tehsil /

5.

Block /

6. Village /

7. PIN Code /

8. Street Address or any other landmark /

Current Address /1. Address is same as permanent address? /

?

2. Address is Out of state? /

?

3. State /

4. District /

5. Tehsil /

6.

Block /

7. Village /

8. PIN Code /

9. Street Address or any other landmark /



Page 5 of 7

List of Required Documents /

Category of Document / Mandatory/ Optional /

Application From parent or Guardian/ Mandatory /

Birth Certificate in Original / ਜਨਮ Mandatory /

Self Declaration / Mandatory /

School certificate(attested copy)/Passport/Driving

License /

, ,

ਜਨਮ ਦਰਜ

Mandatory /

Note: At the time of upload/submission of e-Form, please make sure to attach the mentioned documents.

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Page 7 of 7

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