Section 19, Rajasthan Registration of Births…

Rajasthan Registration of Births and Deaths Rules, 2000State Rules of Rajasthan · 1969

As from the coming into force of these rules, the Registration of Births and Deaths Rules, 1972 shall stand repealed:-

Provided that any order made or action taken under the rules so repealed shall be deemed to have been made or taken under provisions of these rules.

Format of the Report on the Working of the Act [See Rule 4]

1. Brief description of the 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 or births and deaths.

8. Progress in the medical certification of cause of death.

9. Maintenance of Records.

10. Search of birth and death 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 Instructions issued under the Act.

15. General remarks.

In the case of multiple births, fill in a separate form for each child and write "Twin birth" or "Triple birth" etc., as the case may be, in the remarks column in the box below left.

Form No. 1 [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 : (Enter "male" or "female", 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) 5 Name of the mother :

(Full name as usually written) 6 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)

1. Hospital/Institution Name :

2. House Address:

7 Informant's name :

Address :

(After completing all columns 1 to 20, 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:

Town/Village : District:

Remarks : (if any) Name and Signature of the Registrar [Form No. 1] [See Rule 5] Birth Report Statistical Information This part to be detached and sent for statistical processing To be filled by the informant 8 Town or Village of Residence of the mother : (place where the mother usually to lives. This can be different from the place where the delivery occurred. The house address is not required to be entered).

(a) Name of town/Village:

(b) Is it town or village : (Tick the appropriate entry below)

1. Town 2. Village

(d) Name of State :

9 Religion of the Family : (Tick the appropriate entry below)

1. Hindu 2. Muslim 3. Christian

4. Any other religion : (write name of the religion) 10 Father’s level of education : (Enter the completed level of education e.g. if studied up to class VII but passed only class VI, write class VI.)

11 Mother’s level of education : (Enter the completed level of education e.g. if studied up to class VII but passed only class VI, write class VI.)

12 Father’s occupation : (if no occupation write Nil) 13 Mother’s occupation : (if no occupation write Nil) 14 Age of mother (in completed years) at the time of marriage : (If married more than once, age at first marriage may be entered) 15 Age of the mother (in completed years) at the time of this birth :

16 Number of children born alive to the mother so far including this child : (Number of children born alive to include also those from earlier marriage(s), if any) 17 Type of attention at delivery : (Tick the appropriate entry below)

1. Institutional-Government

2. Institutional-Private or Non-Government

3. Doctor, Nurse or Trained midwife

4. Traditional Birth Attendant

5. Relatives or Others.

18 Method of Delivery : (Tick the appropriate entry below)

1. Natural 2. Caesarean 3. Forceps/Vacuum 19 Birth Weight (in kgs) : (if available) 20 Duration of pregnancy : (in weeks) (Columns to be filled are over, now put signature at left) To be filed by the Registrar Registration No. Registration Date :

Date of Birth :

Sex 1. Male 2. Female Place of Birth : 1. Hospital/Institution 2. House Name Code No.

District:

Tehsil:

Town/Village Registration Unit:

Name and Signature of the Registrar Form No. 2 [DEATH REPORT] Legal Information This part to be added to the Death 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) 3 Sex of the deceased : (Enter "male" or "female", do not use abbreviation) 4 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) 5 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 :

2. House Address:

3. Other places :

6 Informant's name :

Address :

(After completing all columns 1 to 17, 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 :

Town Village : District :

Remarks(if any) Name and Signature of the Registrar [Form No. 2] [See Rule 5] Death Report Statistical Information This part to be detached and sent for statistical processing To be filled by the informant 7 Town or Village of Residence of the deceased : (place where the deceased actually lived. This can be different from the place where the death occurred. The house address is not required to be entered).

(a) Name of town/Village:

(b) Is it town or village : (Tick the appropriate entry below)

1. Town 2. Village

(d) Name of State:

8 Religion : (Tick the appropriate entry below)

1. Hindu 2. Muslim 3. Christian 4. Any other religion : (write name of the religion) 9 Occupation of the deceased : (If no occupation write ‘Nil’) 10 Type of medical attention received before Death : (Tick the appropriate entry below)

1. Institutional

2. Medical attention other than institution

3. No medical attention Name Code No.

District:

Tehsil:

Town/Village Registration Unit:

To be filled by the informant 11 Was the cause of death medically certified ?: (Tick the appropriate entry below)

1. Yes 2. No 12 Name of Disease or Actual Cause of Death :

(For all deaths irrespective of whether medically certified or not) 13 In case this is a female death, did the death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy :

(Tick the appropriate entry below)

1. Yes 2. No 14 If used to habitually smoke-for how many years ?:

15 If used to habitually chew tobacco in any form for how many years ?:

16 If used to habitually chew arecanut in any form (including pan masala)-for how many years ?:

17 If used to habitually drink alcohol-for how many years ?:

(Columns to be filled are over. Now put signature at left) To be filled by the Register Registration No. Registration Date :

Date of Death : Sex 1. Male 2. Female Age: Years/months/days/hours Place of Death :

1. Hospital/Institution 2. House

3. Other Place Name Code No.

District:

Tehsil:

Town/Village Registration Unit:

Name and Signature of the Registrar Form No. 3 In the case of multiple, births, fill in a separate form for each Child & write "Twin birth" or "Triple birth" etc. as the case may be, in the remarks column in the box below left Still Birth Report Legal Information The part to be added to the Still Birth Register Still Birth Report Statistical Information This part to be detached and sent for statistical processing .

To be filled by the informant

1.Date of Birth: (Enter the exact day, month and year the Birth took place e.g. 1.1.2000)

2. Sex :(Enter 'male' or 'female', do not use abbreviation)

3. Name of the Father:(Full Name as usually written)

4. Name of the Mother: (Full Name as usually written)

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.

Hospital/Institution Name :

2. House Address :

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 informant

7. Town or Village or Residence of the mother:

(Place where the mother usually lives. This can be different from the place where the delivery occurred. The House address is not required to be entered)

(a) Name of Town or Village :

(b) Is it a town or village : (tick the appropriate below)

1. Town 2. Village

(d) Name of State

8. Age of the mother (In completed years) at the time of this birth

9. Mother's level of education :

(Enter the completed level of education e.g.

if studied upto class VII but passed only class VI, write class VI

10. Type of attention at delivery :(Tick the appropriate entry below)

1. Institutional-Governmental

2. Institutional-Private or Non- Government

3. Doctor, Nurse or Trained midwife

4. Traditional Birth Attendant

5. Relative or others

11. Duration of pregnancy : (In weeks)

12. Cause of foetal death : (if known) (column to be filled are over. Now put signature at left) To be filled by the Registrar To be filled by the Registrar Registration No.:

Registration Unit Town/Village :

Remarks (if any) Registration Date : Name Code No. Registration No.:

Registration Date :

Date of Birth Sex : 1. Male 2. Female District Tehsil Town/Village District : Place of Birth:

Hospital/Institution

House Name and Signature of the Registrar Registration Unit Name and Signature of the Registrar Form No. 4 [See Rule 7] Medical Certificate of Cause Of Death (Patient in Hospital, not to be used for still births) To be sent to Registrar along with form 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 Statistical office Sex Age at Death If 1 year or more If less than 1 year If less than one Month, age in Days If less than one day, age in hours

1. Male

2. Female CAUSE OF DEATH Interval between on set & death approx.

I. Immediate cause State the disease, injury or Due to (or as a consequences of) complication which caused Death, not the mode of dying such as heart failure, Asthenia, etc.

Antecedent cause Morbid conditions, if any, giving Due to (or as consequences of ) rise to the above cause, stating Under lying conditions last

(a) ….................... Due to (or as a consequences of)

(b) ….................... Due to (or as a consequences of)

II.

Other significant conditions contributing to the death but not related to the disease or conditions causing it.

………………………………… Manner of Death How did the injury occur?

1. Natural 2. Accident 3. Suicide 4. Homicide

5.Pending investigation 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 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) Medical Certificate Of Cause Of Death Directions for completing the form Name of deceased. - To be given 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 Death. - 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) or part I, and nothing more need be written in the rest or 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 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 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 risk 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 peneumonia; (b) Fracture of neck of femur; (c) Fall from ladder at home.

Maternal deaths. - Be sure to answer the questions 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.

Completness 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. Neoplasms-Indicate whether benign or malignant, and site, with site of primary neoplasm, whenever possible, Heart 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. Dysentry-Specify whether bacillary, amoebic, etc., if known, Complications of pregnancy or delivery-Describe the complication specifically¬Tuberculosis-Give organs affected.

Symptomatic statement. - Convulsions, diarrhoea, 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 cause 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 invaribly be filled in and the manner of death should be shown as "Pending investigation".

Form No. 4-A [See Rule 7] Medical Certificate of Cause of Death (For non-institutional deaths, Not to be used for still births) To be sent to Registrar along with Form 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 Statistical office Sex Age at Death If 1 year or more If less than 1 year If less than one Month, age in Days If less than one day, age in hours

1. Male

2. Female CAUSE OF DEATH Interval between on set & death approx.

I. Immediate cause State the disease, injury or Due to (or as a consequences of) complication which caused Death, not the mode of dying such as heart failure, Asthenia, etc.

Antecedent cause Morbid conditions, if any, giving Due to (or as consequences of ) rise to the above cause, stating Under lying conditions last

(a) ….................... Due to (or as a consequences of)

(b) ….................... Due to (or as a consequences of)

II.

Other significant conditions contributing to the death but not related to the disease or conditions causing it.

………………………………… Medical Certificate Of Cause Of Death Directions for completing the form Name of deceased. - To be given 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 years 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 Death. - 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, line (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.

This does not mean the mode of dying, e.g,. heart failure, respiratory failure, etc. These terms should not 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 under lying cause to be tabulated is always written 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 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 risk 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" If deceased was a female, was pregnancy the death associated with ? If yes, was there a delivery ?

1. Yes 2. No.

Name and signature of the Medical Practitioner certifying the cause of death Date of Certification …........................

See Reverse For Instruction (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.................. and he/she expired on.................. at.................. A.M./P.M.

Doctor....................

Signature and address of Medical Practitioner/Medical attendant with Registration No.

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.

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, if 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. Neoplasms- indicate whether benign or malignant, and site, with site of primary neoplasm, whenever possible, heart 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. Dysentry - Specify whether bacillary, amoebic, etc., if known. Complications of pregnancy or delivery - Describe the complication specifically. Tuberculosis -Give organs affected.

Symptomatic statement. - Convulsions, diarrhoea, 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.

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.

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, if 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.

[FORM NO. 5] [See Rule 8] BIRTH CERTIFICATE (Issued under Sec. 12/17) This is to certify that the following information has been taken from the original record of birth which is the register for (Local area)........... of Tehsil................of District............... …...........of State……………...

Name...........................................................................................................

Sex:.................................

Date of Birth……………………………………… Place of Birth:...........................................................

Name of Father:...............................

Name of Mother:................................

Registration No................

Date of Registration............................

Date...................... Signature of the issuing authority Seal [FORM NO. 6] [See Rule 8] DEATH CERTIFICATE (Issued under Sec. 12/17) This is to certify that the following information has been taken from the original record of death which is the register for (local area)........... of Tehsil................of District............... …...........of State……………...

Name...........................................................................................................

Sex:.................................

Date of Death……………………….

Place of Death:...........................................................

Registration No................

Date of Registration............................

Date...................... Signature of the issuing authority Seal No disclosure shall be made of particulars regarding the cause of death as entered in the Register. See proviso to Section 17 (1) [FORM NO. 7] [See Rule 12] BIRTH REGISTER FORM 1 : 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 : (Enter "male" or "female", 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) 5 Name of the mother :

(Full name as usually written) 6 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)

1. Hospital/Institution Name :

2. House Address:

7 Informant's name :

Address :

(After completing all columns 1 to 20, 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:

Town/Village : District:

Remarks : (if any) Name and Signature of the Registrar [FORM NO. 8] [See Rule 12] Death Register Form No. 2 Death Report Legal information This part to be added to the Death 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. Hospital/Institution Name :

2. House Address:

3. Other places :

6 Informant's name :

Address :

(After completing all columns 1 to 17, 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 :

Town /Village :

District :

Remarks: (if any) Name and Signature of the Registrar FORM NO. 9 [See Rule 12] Form No. 3 STILL BIRTH REGISTER STILL BIRTH REPORT Legal information This part to be added to the Still Birth Register To be filled by the informant

1. Date of Birth : (Enter the exact day, month and year e.g. 1.1.2000)

2. Sex :(Enter "male" or "female") “do not use abbreviation”

3. Name of the father :

(Full name as usually written)

4. Name of the mother :

(Full name as usually written )

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 :

2. House Address

3. Other place

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 filed by the Registrar Registration No. Registration Date :

Registration Unit :

Town/Village : District :

Remarks : (if any) Name and Signature of the Registrar FORM NO. 10 [See Rule 13] NON-AVAILABILITY CERTIFICATE (Issued under Section 17 of the Registration of Births & 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 year(s) ..................relating to (Local area).................. of (Tehsil).................. of (District)..................

of (State).................. and found that the event relating to the birth/death of..................

son/daughter of.................. was not registered.

Date ........ Signature of issuing authority Seal FORN 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 to equal to the number of Statistical Part of Birth Reporting Forms (Form No. 1) attached with this monthly report Dated: Signature & Name of the Registrar:

Submitted to the Chief Registrar/District Registrar.

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 Deaths Maternal Deaths Registered within one year of occurrence Registered after one year of occurrence Total* 1 2 3 4 5 Note - Infant and Maternal Deaths should also be included in the Deaths.

*Total should be equal to number of Statistical Part of Deaths Reporting Forms (Form No.

2) attached with this monthly report.

Dated: Signature & Name of the Registrar Submitted to the Chief Registrar/District Registrar 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 Still 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 & Name of the Registrar Submitted to the Chief Registrar/District Registrar.

Actual Adjusted for incomplete Receipt of Returns Total Adjusted for Incomplete Receipt of Returns No. of Monthly Returns not Received Table A-1 Population, Registration Units, Monthly Returns Due and Received (Rural Areas) State Total Population as per last Census Estimated Mid-year population Sl No. District No. of Registration Units No. of Monthly Returns Due Actual Adjusted for incomplete Receipt of Returns Total Adjusted for Incomplete Receipt of Returns State Total Table A-2 Population, Registration Units, Monthly Returns Due and Received (Urban Areas) Sl No. District Population as per last Census No. of Registration Units No. of Monthly Returns Due No. of Monthly Returns not Received Estimated Mid-year population M F T Within the Area Outside the Area 1 District-1 R U T Towns with Poputation one lakh and above Town-1 Town-2 2 District-2 State Total R U T Table B-1 Live births by Place of Occurrence, Districts (Rural & Urban) and Towns with Population One lakh and above Births by Place of Occurrence Place of Residence of Mother DistrictS.No. Place of Residence outside the State Birth Rate M F T Within the Area Outside the Area 1 2 3 4 5 6 7 8 1 District-1 R U T Towns with Poputation one lakh and above Town-1 Town-2 2 District-2 State Total R U T S.No. District Births by Place of Residence of Mother Place of occurrence of The Birth TABLE B-2 Live Births by Place of Residence, Districts (Rural & Urban) and Towns with Population One Lakh and above After 1 year After 1 year Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Number of Live Births Registered S.No.

TABLE B-3 Time Gap in Registration of Live Births (Rural & Urban) State Total Urban Number of Live Births Registered Within Prescribed Time limit Delayed Registration Within 30 days After 30 days but within 1 yearWithin Prescribed Time Limit Delayed Registration] Within 30 days After 30 days but within 1 year District Rural January February March April May June July August September October November December Total 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 M F T M F T TABLE B-4 Live Births by Sex and Month of Occurence State Total Months SexDistrict Sl. No.

Government Private and Non - Government 1 2 3 4 5 6 7 8 Rural Urban

(i) Towns with population one lakh and above Town-1 Town-2

(ii) All other Urban areas Urban Total State Total TABLE B-5 Live BirthS by Type of Attention at Delivery (Rural & Urban) Rural/Urban Total Type of Attention at Delivery Institutional Doctor, Nurse and Trained Midwife Traditional birth Attendant Relatives and Others Not Stated R U T R U T R U T 1 2 3 4 5 6 7 8 9 10 Natural Caesarean Forceps/Vaccum Not Stated State Total TABLE B-6 Method of Delivery Type of Institution Government Hospital Private and Non-Government Total Live Births by Method of Delivery and Type of Instituion for Institutional Births (Rural & Urban) 1 2 3 4 5 6 7 8 9 10 11 12 13 & above Not Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/Urban Areas Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above Age Not Stated Total Birth Order TotalAge of Mother TABLE B-7 Live Births by Age of the Mother and Birth Order (Rural & Urban) 1 2 3 4 5 6 7 8 9 10 11 12 13 & above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above Age Not Stated Total TABLE B-8 Live Births by Birth Order and Age of the Mother for Towns with Population 1 Lakh and above Age of Mother Birth Order Total Illiterate Below Primary Primary But below Matric Matric But below Graduate Graduate & Above Not Stated 1 2 3 4 5 6 7 8 All Areas/Rural Areas/Urban Areas Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above Age not Stated Total Age of Mother Level of Education of the Mother TABLE B-9 Live Births by Age and Level of Education of the Mother (Rural & Urban) Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/Urban Areas Illiterate Below Primary Primary but Below Matric Matric but below Graduate Graduate & above Not Stated Total TABLE B-10 Live Births by Level of Education of the Father and Birth Order(Rural & Urban) Level of Education of Father Live Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/Urban Areas Illiterate Below Primary Primary but Below Matric Matric but below Graduate Graduate & above Not Stated Total TABLE B-11 Live Births by Level of Education of the Mother and Birth Order(Rural & Urban) Level of Education of Mother Live Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All educational levels/Illiterate/Below primary/Primary but below Matric/Matric but below graduate/Graduate and above Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above Age not Stated Total All Educational Level also includes the education level not stated TABLE B-12 Live Births by Age of Mother and Birth Order for each level of Education of the Mother (Rural) Age of Mother Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All educational levels/Illiterate/Below primary/Primary but below Matric/Matric but below graduate/Graduate and above Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above not Stated Total All Educational Level also includes the education level not stated TABLE B-13 Live Births by Age of Mother and Birth Order for each level of Education of the Mother (Urban) Age of Mother Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Religions*/Hindus/Muslims/Christians/Sikhs/Others Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above not Stated Total Religion not stated have been included in "All religions" Minor religious groups have been combined under "Others" TABLE B-14 Live Births by Age of Mother, Birth Order and Religion of the Family (Rural) Age of Mother Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Religions*/Hindus/Muslims/Christians/Sikhs/Others Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above not Stated Total Religion not stated have been included in "All religions" Minor religious groups have been combined under "Others" TABLE B-15 Live Births by Age of Mother, Birth Order and Religion of the Family (Urban) Age of Mother Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/ Urban Areas Professional, Technical and Related workesr Administrative Executive and Managerial workers Clerical and Related workers Sales workers Service workers Farmers, Fishermen, Hunters, Loggers etc. and Related workers Producation and other related workers, Transport Equipment Operators and labourers workers whose Occupation are not elsewhere classified Non-workers Total TABLE B-16 Live Births by Occupation of the Father and Birth Order (Rural & Urban) Occupation of Father Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/ Urban Areas Professional, Technical and Related workesr Administrative Executive and Managerial workers Clerical and Related workers Sales workers Service workers Farmers, Fishermen, Hunters, Loggers etc. and Related workers Producation and other related workers, Transport Equipment Operators and labourers workers whose Occupation are not elsewhere classified Non-workers Total TABLE B-17 Live Births by Occupation of the Mother and Birth Order (Rural & Urban) Occupation of Mother Birth Order Total 1 2 3 4 5 6 7 8 9 10 11 12 13& above Note Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Areas/Rural Areas/ Urban Areas 0&4 5&9 10&14 20-24 25-29 30 & above Not Stated Total TABLE B-18 Live Births by Duration of Marriage of the Mother and Birth Order (Rural & Urban) Duration of Marriage (In Years) Birth Order Total Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45&above Not Stated 1 2 3 4 5 6 7 8 9 10 11 All Areas/Rural Areas/ Urban Areas 0&4 5&9 10&14 15&19 20-24 25-29 30 & above Not Stated Total Duration of Marriage Age of Mother Total TABLE B-19 Live Births by Duration of Marriage and Age of the Mother (Rural & Urban) R U T R U T R U T R U T R U T R U T R U T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 <32 32-36 37-39 40 41+ Not Stated Total Birth Weight (in Kgs) Total TABLE B-20 Live Births by Duration of Pregnancy and Birth Weight (Rural & Urban)

3.000-4.000 Duration of Pregnancy (In weeks)

4.000+ Not StatedLess than 1.500 1.500-2.000 2.000-3.000 R U T R U T R U T R U T R U T R U T R U T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Below 15 15&19 20-24 25-29 30-34 35-39 40-44 45 & above Not Stated Total Not Stated TABLE B-21 Live Births by Age of the Mother and Birth Weight (Rural and Urban) Age Mother Birth Weight (in Kgs) Total Less than 1.500 1.500-2.000 2.000-3.000 3.000-4.000 4.000+ R U T R U T R U T R U T R U T R U T R U T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 1 2 3 4 5 6 7 8 9 Total Table B-22 Live Birth By Birth Order and Birth Weight (Rural & Urban) Birth Order Less than 1500 1500-2000 2000-3000 3000-4000 4000 + Not Stated Birth Weight (in Kgs) Total 10 & Above Not Stated Total Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 & above not stated 1 2 3 4 5 6 7 8 9 10 11 Natural Caesarean Not Stated Total Forceps/ Vacuum Method of Delivery Age of Mother All Areas/ Rural Areas/ Urban Areas Table B-23 Live Births by Method of Delivery and Age of the Mother (Rural & Urban) District M F T With the Area Outside the Area 1 2 3 4 5 6 1 District/1 R U T Town with Population one Lakh and above Town -1 Town -2 2 District/2 R U T R U T State Total Death By Place of Occurrence, Districts (Rural & Urban) and Towns with Population One Lakh and above.

Table D-1 Sl. No.

Death by Place of Occurrence Place of Residence of Deceased Place of Residencet out side the State 7 8 District M F T Within the Area 1 2 3 4 5 6 1 District/1 R U T Town with Population one Lakh and above Town -1 Town -2 2 District/2 R U T R U T State Total Death rate Place of Occurrence of Death Outside the Area Table D-2 Death By Place of Residence, Districts (Rural & Urban) and Towns with Population One Lakh and above.

Sl. No.

Death by Place of Residence 7 8 Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 State Total Urban Sl. No. District Within Prescribed Time Limit Table D-3 Time Gap in Registration of Deaths (Rural & Urban) After 1 year Number of Deaths Registered Delayed RegistrationWithin Prescribed Time Limit Within 30 days After 30 days but within 1 year After 1 year Within 30 days After 30 days but within 1 year Rural Sl. No. District Sex Total January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 M F T State Total M F T Month Deaths by sex and Month of Occurrence Table D-4 1 2 3 4 5 Rural Urban

(1)Town with Population 1 lakh & above Town -1 Town -2

(2) All other Urban areas Urban Total State Total Table D-5 Medical Attention other than InstitutionInstitutional No Medical Attention Type of Attention at Death Deaths by Type of Attention at Death (Rural & Rural) Rural/Urban Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Below 1 Year 1-4' 5-14' 15-24' 25-34' 35-44' 45-54' 55-64' 65-69' 70 and above Age not stated Total *Minor religious group may be classified into others All Areas/Rural Areas/Urban Areas Total Religion of the Deceased Table D-6 Hindus Muslins Christians others* Deaths by Age, Sex and Religion of the Deceased (Rural & Urban) Age Sex Total 10&14 15&24 25&34 35&44 45&54 55&64 65&69 70 and above Age not Stated 2 3 4 5 6 7 8 9 10 11 12 M F T M F T Clinival and Related workers M F T Sales Workers M F T Service Workers M F T M F T M F T M F T M F T M F T Occupation of the Deceased 1 Table D-7 Deaths by Age, Occupation and Sex (Rural) Total Professional Technical and Related workers Administrative Executive and Managerial workers Farmers, Fishermen, Hunters, etc and Related workers Production and other related workers, Transport Equipment Operators and Labourers Workers whose Occupation are not elsewhere classified Non workers OccupatIon of the Deceased Sex Total 10-14 15-24 25-34 35-44 45-54 55-64 65-69 70 and above Age not Stated 1 2 3 4 5 6 7 8 9 10 11 12 M F T 1 M F T M F T M F T M F T M F T M F T M F T M F T M F T Table D-8 Deaths by age, Occupation and sex (Urban) Total Professional, Technical and retated workers Administrative Execuitive and Managerial workers Cierical and Related workers Sales workers Service workers Farmers, Fishermen, Hunters, Loggers etc and Related workers Production and other related workers, Transport Equipment Operators and Labourers Workers whose Occupation are not eisewhere classified Non-workers Occupation of The Deceased Sex Total 10-14 15-24 25-34 35-44 45-54 55-64 65-69 70 and above Age not Stated 1 2 3 4 5 6 7 8 9 10 11 12 M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T Total Professional, Technical and retated workers Administrative Execuitive and Managerial workers Cierical and Related workers Sales workers Service workers Farmers, Fishermen, Hunters, Loggers etc and Related workers Table D-9 Deaths by Age, Occupation and sex (All Areas) Production and other related workers, Transport Equipment Operators and Labourers Workers whose Occupation are not eisewhere classified Non-workers Belows1 years 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-69 70 and above Age notStated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 M F T Total M F T Deaths by Cause of Death, Age and Sex all Deaths Medically Certified or Not Table D-10 Sl. No. cause of death Sex Agse of the Deceased Total si. cause of death Sex Total no. Belows1 years 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-69 70 and above Age not Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 M F T Total M F T Deaths by Cause of Death, Age and Sex for Medically Certified Deaths Agse of the Deceased Table D-11 Table D-13 Si District Infant No M F T Mortality Rate within the Area Outside the Area 1 2 3 4 5 6 7 8 1 District-1 R U T Town-1 town-2 2 District-2 R U T State Total R U T Infant Deaths by place of Residence, Districts (Rural & Urban) and Towns with population One Lakh and above.

Deaths by Place of Residence of Mother place of occurrence town with Population one lak and above Table D-13 Table D-12 Si District No M F T within the Area Outside the Area 1 2 3 4 5 6 7 8 1 District-1 R U T Town-1 town-2 2 District-2 R U T State Total R U T Deaths by Place of Occurence town with Population one lak and above Infant Deaths by place of Occurence, Districts (Rural & Urvan) and Towns with population One Lakh and above.

Place of Residence of Mother Place of Residence out side the State Table D-14 Si Age Rural Urban All Areas No. Male Femal Total Male Femal Total Male Femal Total 1 2 3 4 5 6 7 8 9 10 11 1 7 days 2 7 day 28 days 3 28 days-1 years 4 Age not stated Total Infant Deaths by Age and Sex (Rural & Urben) Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45& Above Not Stated 1 2 3 4 5 6 7 8 9 10 11 Total All Areas/Rural Areas/Urban Areas Table D-15 pregnancy Related Deaths by Age Group of the Deceased and Cause of Death for Medically Certified Deaths (Rural & Urban) Cause of Death Age of the deceased Total Total Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45& Above Not Stated 1 2 3 4 5 6 7 8 9 10 11 Total Table D-16 All Areas/ Rural Areas/ Urbain Areas Age of the Deceased Pregnancy Related Deaths by Age Group of the Deceased and Cause of Death for all Deaths Medically Certified or not (Rural & Urban) Cause of Death Age Illiterate Below Primary but Matric but Graduate Not Total Primary below Matric below Graduate & Above Stated 1 2 3 4 5 6 7 8 Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45& Above Not Stated Total Pregnancy Related Deaths by Age and Level of Education (Rural & Urban) Table D-17 Rural Areas/ Urbain Areas /All Areas Level of Education Occupation of the Deceased Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45& Above Not Stated 1 2 3 4 5 6 7 8 9 10 11 Professional Technical and Related workers Administrative Executive and Managerial Workers Clerical and Related workers Sales Workers Service workers Farmer, Fishermen, Hunters, Loggers etc and Labourers Producation and other related workers Transport Equipment operators and labourers Workers whose Occupation are not elesewhere classifed Non- workers Total Table D-18 All Areas/ Rural Areas/ Urbain Areas Table D18: Pregnancy Related Deaths by Age and occupation (Rural & Urban) Age of the Deceased Total SI. Selected Cause Sex No. of Death Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45-54 55-64 65-69 70 and avove age ont stated 1 2 3 4 5 6 7 8 9 10 11 12 13 M Only smoking/only Chewing Tobacco/only Chewing Arecanut/ F Only Drinking Alcoltol/Smoking and Chewing Tobacco/Smoking and T Chewing Arecanut/Chewing Tabacco and Drinking Alcohol/Chewing Tabacco and Arecanut/Chewing Tabocco and Drinking Alcohol/ Chewing arecanut and Drinking Alcohol/Smoking Chewing Tabacco and Arecanut/smoking, Chewing Tobacco and Drinking alcohol/Smoking, Chewing Arecanut and Drinking Alcohol/Chewing Tobacco Arecanut and Drinking Alcohol/All Habit/Habit Not Known Age of the Deceased Total Table D-19 Deaths by Selected Cause of Death, Age, Sex and Habit (Rural ) SI. No. Selected Cause of Death Sex Total Below 15 15-24 25-34 35-44 35-54 55-64 65-69 70 and above Age not Stated 1 2 3 4 5 6 7 8 9 10 11 12 13 M Only smoking/only Chewing Tobacco/only Chewing Arecanut/ F Only Drinking Alcoltol/Smoking and Chewing Tobacco/Smoking and T Table D-20 Chewing Arecanut/Chewing Tabacco and Drinking Alcohol/Chewing Tabacco and Arecanut/Chewing Tabocco and Drinking Alcohol/ Chewing arecanut and Drinking Alcohol/Smoking Chewing Tabacco and Arecanut/smoking, Chewing Tobacco and Drinking alcohol/Smoking, Chewing Arecanut and Drinking Alcohol/Chewing Tobacco Arecanut and Drinking Alcohol/All Habit/Habit Not Known Age of the Deceased Deaths by Selected Cause of Death, Age, Sex and Habit (Urban ) Sex Below 15 15-24 25-34 35-44 45-54 55-64 65-69 70 and avove Age ont stated 1 2 3 4 5 6 7 8 9 10 11 12 13 M Only smoking/only Chewing Tobacco/only Chewing Arecanut/ F Only Drinking Alcoltol/Smoking and Chewing Tobacco/Smoking and T Table D-21 Deaths by Selected Cause of Death, Age, Sex and Habit (All Areas ) Chewing Arecanut/Chewing Tabacco and Drinking Alcohol/Chewing Tabacco and Arecanut/Chewing Tabocco and Drinking Alcohol/ Chewing arecanut and Drinking Alcohol/Smoking Chewing Tabacco and Arecanut/smoking, Chewing Tobacco and Drinking alcohol/Smoking, Chewing Arecanut and Drinking Alcohol/Chewing Tobacco Arecanut and Drinking Alcohol/All Habit/Habit Not Known Age Group TotalSelected Cause of DeathSl. No.

Sl.No. District Place of Residence M F T Within the Area Outside the Area Cutside the State 1 2 3 4 5 6 7 8 State Total R U T Place of Residence of Mother Table S-1 Still Birth by Place of Occurrence in Districts (Rural & Urban) Still Births by Place of Occurrence Sl District Still Birth No. M F T Rate Within the Area Cutside the State 1 2 3 4 5 6 7 8 State Total R U T Table S-2 Still Birth by Place of Residence in Districts (Rural & Urban) Still Births by Place of Residence of Mother Place of Occurrence of Still Birth Male Female Total Male Female Total Male Female Total 1 2 3 4 5 6 7 8 9 10 Below 15 years 15-19 20-24 25-29 30-34 35-39 40-44 45 & above Age not stated Total Table S-3 Still Births by Sex and Age of the Mother (Rural & Urban) Rural Areas Urban Areas All AreasAge of Mother Still Births Male Female Total Male Female Total Male Female Total 1 2 3 4 5 6 7 8 9 10 < 32 32-36 37-39 40 41+ not stated Total Table S-4 Still Births by Sex and Duration of Pregnancy (Rural & Urban) Rural Areas Urban Areas All AreasDuration of Pregnancy (in weeks) Still Births Rural/Urban Government Private and Non-Government 1 2 3 4 5 6 7 8 Rural Urban

(i) Towns with population one lakh and above Town-1 Town-2

(ii)All Other Urban areas Urban Total State Total Type of Attention at Deliyery Total Table S-5 Still Birth by sex and Type of Medical Attention Received at Delivery (Rural & Urban) Institutional Doctor, Nurse and Trained midwife Traditional Birth Attendant Relatives and Others Not Stated Below 15 15-19 20-24 25-29 30-34 35-39 40-44 45& Above Age not Stated 1 2 3 4 5 6 7 8 9 10 11 12 Total Rural Areas/ Urbain Areas/ All Areas Still Birth by Cause of Still Births and Age of The Mother (Rural & Urban) Table S-6 Age of Mother TotalSl. No. Cause of Still Births Below 32 36-36 37-39 40 41+ Not Stated 1 2 3 4 5 6 7 8 9 Total { No. F. 16 (1) Statistics/99} By Order of the Governor ,- eq[kksik/;k;]

Secretary (Plan) Government of Rajasthan Table S-7 Still Birth by Cause of Still Births and Age of The Mother (Rural & Urban) Rural Areas/ Urbain Areas/ All Areas Age of MotherSl. No.

Duration of Pregnancy (In weeks) Total STATISTICS DEPARTMENT NOTIFICATION Jaipur, November 23, 2007 G.S.R.81.- In exercise of the powers conferred by section 30 of the Registration of Births and Deaths Act, 1969 (Central Act No. 18 of 1969), the State Government with the approval of the Central Government, hereby makes the following rules further to amend the Rajasthan Registration of Births and Death Rules, 2000; namely:-

1. Short title and commencement .- (1) These rules may be called the Rajasthan Registration of Births and Deaths (Amendment) Rules, 2007

(2) They Shall come into force on the date of their publication in the official Gazette.

2. Amendment of Forms .- The existing form No. 1,2,5,6,7 and 8 appended to the Rajasthan Registration of Births and Deaths Rules, 2000 shall be substituted by the following Forms respectively;

namely:- [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 : (Enter "male" or "female", 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) 5 Name of the mother :

(Full name as usually written) 6 Permanent address of the Parents:

7 Address of Parents at the time of birth :

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)

1. Hospital/Institution Name :

2. House Address:

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:

Town/Village : District:

Remarks : (if any) Name and Signature of the Registrar [Form No. 1] [See Rule 5] Birth Report Statistical Information 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" or "Triple birth" etc., as the case may be, in the remarks column in the box below left.

To be filled by the informant 10 Town or Village of Residence of the mother : (place where the mother usually lives. This can be different from the place where the delivery occurred. The house address is not required to be entered).

(a) Name of town/Village:

(b) Is it town or village : (Tick the appropriate entry below)

1. Town 2. Village

(d) Name of State :

11 Religion of the Family : (Tick the appropriate entry below)

1. Hindu 2. Muslim 3. Christian

4. Any other religion : (write name of the religion) 12 Father’s level of education : (Enter the completed level of education e.g. if studied up to class VII but passed only class VI, write class VI.)

13 Mother’s level of education : (Enter the completed level of education e.g. if studied up to class VII but passed only class VI, write class VI.)

14 Father’s occupation : (if no occupation write Nil) 15 Mother’s occupation : (if no occupation write Nil) To be filed by the Registrar Name Code No.

District:

Tahsil:

Town/Village :

Registration Unit:

16 Age of mother (in completed years) at the time of marriage : (If married more than once, age at first marriage may be entered) 17 Age of the mother (in completed years) at the time of this birth :

18 Number of children born alive to the mother so far including this child : (Number of children born alive to include also those from earlier marriage(s), if any) 19 Type of attention at delivery : (Tick the appropriate entry below)

1. Institutional-Government

2. Institutional-Private or Non-Government

3. Doctor, Nurse or Trained midwife

4. Traditional Birth Attendant

5. Relatives or Others.

20 Method of Delivery : (Tick the appropriate entry below)

1. Natural 2. Caesarean 3. Forceps/Vacuum 21 Birth Weight (in kgs) : (if available) 22 Duration of pregnancy : (in weeks) (Columns to be filled are over, now put signature at left) Registration No. Registration Date :

Date of Birth :

Sex 1. Male 2. Female Place of Birth : 1. Hospital/Institution 2. House Name and Signature of the Registrar [DEATH REPORT] Legal Information This part to be added to the Death 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) 3 Sex of the deceased : (Enter "male" or "female", do not use abbreviation) 4 Name of the Father/Husband of the deceased:

(Full name as usually written) 5 Name of the mother of the deceased :

(Full name as usually written) 6 Permanent address of the deceased:

7 Address of the deceased at the time of death :

8 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) 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 :

2. House Address:

3. Other places :

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 :

Town /Village : District :

Remarks (if any) Name and Signature of the Registrar [Form No. 2] [See Rule 5] Death Report Statistical Information This part to be detached and sent for statistical processing To be filled by the informant 11 Town or Village of Residence of the deceased : (place where the deceased actually lived. This can be different from the place where the death occurred. The house address is not required to be entered).

(a) Name of town/Village:

(b) Is it town or village : (Tick the appropriate entry below)

1. Town 2. Village

(d) Name of State:

12 Religion : (Tick the appropriate entry below)

1. Hindu 2. Muslim 3. Christian 4. Any other religion : (write name of the religion) 13 Occupation of the deceased : (If no occupation write ‘Nil’) 14 Type of medical attention received before Death : (Tick the appropriate entry below)

1. Institutional

2. Medical attention other than institution

3. No medical attention No. Name Code District:

Tahsil:

Town/Village Registration Unit:

To be filled by the informant 15 Was the cause of death medically certified ?: (Tick the appropriate entry below)

1. Yes 2. No 16 Name of Disease or Actual Cause of Death :

(For all deaths irrespective of whether medically certified or not) 17 In case this is a female death, did the death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy :

(Tick the appropriate entry below)

1. Yes 2. No 18 If used to habitually smoke-for how many years ?:

19 If used to habitually chew tobacco in any form for how many years ?:

20 If used to habitually chew areca nut in any form (including pan masala)-for how many years ?:

21 If used to habitually drink alcohol-for how many years ?:

(Columns to be filled are over. Now put signature at left) To be filled by the Register Registration No. Registration Date :

Date of Death : Sex 1. Male 2. Female Age: Years/months/days/hours Place of Death :

1. Hospital/Institution 2. House

3. Other Place Name and Signature of the Registrar Ikzk:i la 5 [FORM NO. 5] TkUe izek.k i= BIRTH CERTIFICATE ¼tUe vkSj e`R;q jftLVªhdj.k vf/kfu;e 1969 dh /kkajk 12/17 vkSj jktLFkku tUe vkSj e`R;q jftLVªhdj.k fu;e 2000 ds fu;e 8/13 ds v/khu tkjh fd;k x;k½ (Issued under Sec. 12/17 of the Registration of Births and Deaths Act, 1969 and Rule 8/13 of the Rajasthan Registration of Births and Deaths Rules, 2000) ;g izekf.kr fd;k tkrk gS fd fuEufyf[kr lwpuk tUe ds ewy vfHkys[k ls yh xbZ gS tks fd ¼LFkkuh; {ks=/LFkkuh;fudk; ) ...............rglhy/[k.M…............ftyk..............jkT;/ la?k jkT; {ks=…...............dk jftLVj gSA 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 tehsil/block................of District............... …...........of State/Union territory……………………..

uke/Name.......................................................................................................................................

fyax/Sex:.................................tUe frfFk/Date of birth:.................................

tUe LFkku/Place of Birth:....................ekrk dk uke/Name of Mother:....................................

firk dk uke/Name of Father:.................................................................................................

cPps ds tUe ds le; ekrk firk dk irk/Address of parents at the time of birth of the child:...............................

….................................................................................................................

ekrk firk dk LFkk;h irk/Permanent address of parents:……………………………………………………….

.................................................................................................................................................................

…………………………………………………………………………………………………………………………………………………………… jftLVªhdj.k la-/Registration No................jftLVªhdj.ka dh rkjh[k/Date of Registration............................

fVIi.kh/Remarks (if any):..................................................................................

tkjh djus dh rkjh[k/Date of issue.....................................................................

tkjh djus okys izkf/kdkjh ds gLrk{kj/Signature of the issuing authority tkjh djus okys izkf/kdkjh dk irk/Address of the issuing authority eqgj/Seal Ikzk:i la 6 [FORM NO. 6] e`R;q izek.k i= DEATH CERTIFICATE (tUe vkSj e`R;q jftLVªhdj.k vf/kfu;e 1969 dh /kkajk 12/17 vkSj jktLFkku tUe vkSj e`R;q jftLVªhdj.k fu;e 2000 ds fu;e 8/13ds v/khu tkjh fd;k x;k½ (Issued under Sec. 12/17 of the Registration of Births and Deaths Act, 1969 and Rule 8/13 of the Rajasthan Registration of Births and Deaths Rules, 2000) ;g izekf.kr fd;k tkrk gS fd fuEufyf[kr lwpuk e`R;q ds ewy vfHkys[k ls yh xbZ gS tks fd (LFkkuh; {ks=/LFkkuh; fudk; ) ...............rglhy/[k.M…............ftyk..............jkT;/ la?k jkT;

{ks=…...............dk jftLVj gSA 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 tehsil/block................of District............... of State/Union territory.

uke/Name...........................................................................................................

fyax/Sex:.................................e`R;q frfFk/Date of Death:.........................................

e`R;q LFkku/Place of Death:....................ekrk dk uke/Name of Mother:.................................

firk/ifr dk uke/Name of Father/Husband: .........................................................................

e`rd dk e`R;q ds le; dk irk/Address of the deceased at the time of death:………………..

e`rd dk LFkk;h irk /Permanent address of deceased:...............................................................

…...................................................................................................................

jftVªdj.k la./Registration No................jftLVªhdj.ka dh rkjh[k/Date of Registration............................

fVIi.kh/Remarks (if any):..................................................................................

tkjh djus dh rkjh[k/Date of issue.....................................................................

tkjh djus okys izkf/kdkjh ds gLrk{kj/Signature of the issuing authority tkjh djus okys izkf/kdkjh dk irk/Address of the issuing authority eqgj/Seal [Form No. 7] [See Rule 12] BIRTH REGISTER FORM 1 : 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 : (Enter "male" or "female", 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) 5 Name of the mother :

(Full name as usually written) 6 Permanent address of the Parents:

7 Address of Parents at the time of birth :

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)

1. Hospital/Institution Name :

2. House Address:

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:

Town/Village : District:

Remarks : (if any) Name and Signature of the Registrar [Form No. 8] [See Rule 12] Death Register Form No. 2 Death Report Legal information This part to be added to the Death 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) 3 Sex of the deceased : (Enter "male" or "female", do not use abbreviation) 4 Name of the Father/Husband of the deceased:

(Full name as usually written) 5 Name of the mother of the deceased :

(Full name as usually written) 6 Permanent address of the deceased:

7 Address of the deceased at the time of death :

1. Hospital/Institution Name :

2. House Address:

3. Other places :

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 :

Town Village : District :

Remarks: (if any) Name and Signature of the Registrar (No. F. 16(1) Statistics/2005) By Order of the Governor, oh- Jhfuokl] Secretary to the Government GOVERNMENT OF RAJASTHAN PLANNING DEPARTMENT No. F 16(1)/Stat/2005/ Jaipur Dated 04.02.2006 NOTIFICATION In exercise of the powers conferred by section 30 of the Registration of Births and Deaths Act, 1969 (Central Act, No. 18 of 1969), the State Government with the approval 0f the Central Government, hereby makes the following rules, further to amend the Rajasthan Registration of Births and Deaths Rules, 2000, namely

1. Short title and commencement .- (1) These rules may be called the Rajasthan Registration of Births and Deaths (Amendment) Rules, 2005

(2) They Shall come into force on the date of their publication in the official Gazette.

2. Amendment of Rule 9 .- In rule 9 of the Rajasthan Registration of Births and Deaths Rules, 2000, the existing expressions “rupees two”, “rupees five” or “rupees ten” shall be substituted by the expression “rupee one”.

By Order of the Governor, Sd/- (Veenu Gupta) Secretary to Government Planning Department

Act	Rajasthan Registration of Births and Deaths Rules, 2000
Section	19
Marginal note	Repeal and saving
Jurisdiction	State of Rajasthan
Status	In force as published by the source

Section 19: Repeal and saving

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