(1) Any offence punishable un section 23 may be compounded by any officer authorised in this behalf by general or special order of the Chief Registrar, if the officer so authorised is satisfied that the offence has been committed inadvertently or by mistake or for the fir st time, before the institution of criminal proceedings under this Act. |
(2) Any such offence may be compounded on payment of such s um, not exceeding fifty rupees for offences under sub-sections (1), (2) and (3) and not exceeding ten rupees for offences under éut?»secfiun (4) of section 23, as the sa id officer may deem fit.
17. Registers and other records under section 30(2)(k) - (1) The r;agiseer of births, register of deaths and register of stillbirths shall be records of permanent importance and shall not be = dl?ll;yeé.
- */(2) The court orders and orders of the specified authority allowing delayed registration 5 regeived by the Registrar under section 13 shall form an integral part of the register of births, register of deaths and register of stillbirths End shall not be destroyed: Provided that the certificate of cause of death granted under sub-/section (3) of section 10 shall be kept by the Chief Registrar for a period of not less than five years.
(3) Every register of Eirths, register of deaths Snd register of stillbirths shall be kept by the Registrar in his office for a period of twelve months from the end of the Lfal‘andar year to which it relates and thereafter such register shall be transferred . to the District Re strar for saf; custody. i i L T Form No.1 FormNo.1 (See Rule 5) (See Rule 5) Lagel Pt - Birth Notice siarca o o s s o S ( i 1 v i s t pocs g — — > " (See Rule 12) L 4 3 To b e oyt W o b i by e fermant oo Ty e © T ate o Bt (Wee the sctual dave, month ard yeor of O R S W Voo o e S T WOFRAIRIa T rormaly T R Ay B8 GHaremTom W S g M the i o martiogs I omplatc yaies. # mriod oere than dnce, s t B e t et g A s e t e .
e et iroctmmonn .
] S Vilage or Town (Tick the a p p r o p r i a t e entry below) (b} e y E e D .
— (20 Comen i i o i 5 o abswatonl ) Name ofthe chitfary " 2 ( L e a v e b l a n k if not n a m e d ) .
(61 Fathr's name sl nareas s usualyseiten) © tSHa M o t h e r ' s ceme (hu name as ususlly written) - ¥ A e R S 7) Religion of the tamiy (Tick the appropriate entry below) k b B k s 441 ) e o J S T — — 8 M u r n b e r of v brths of the mother (nciuding this bith, number of live births from previous marriages, if any)
(17) Care provided during delivery 0 8 9 1 Burstion of pragrancy (inweeks:
] (Tick the sppropriate entry below) duishiereis e O = o O Loms mese 3 w t P m — 151 8y r u a t i v e s of ochers [ o m — — T k the aspropriats one ram the owing sries] ONrdtnorsy [T] o m e e n [
(3) Forcapevacuum [ ] W o i g h t at birth (nkg)(f avalable):
(549008 tha o e sher Koy e 844 v t colamd Form No. 2 FormNo. 2" i i m“fl_..fl (See Rule 5) o savsatpan A ritnion (i gl 1D 619 S N U D — oee Rl 12) N a — — ‘ o 4 by the k g t " — — he f i l e d by the & formant.
® u.zg Teath:
o p e e o l d e m n { a c n l day. mon, year of d e a t h e 112000 TP Tawn > hogs whers th Ckeevmod 145100 (P whert the deceaied actuaty esden e s e e o 8 i o ol € e t y e e
(3) Name of the townivilage D 0 W - {Full n a m e as it is usually written) ® S —
(b) Town o Village (Tick from the entries given beiow) e y [ T ] o w e [ iwie e o foas ! 45 0% cse sbirevistans) Sex p r e s — R N — 151 Age of e cacussea s m i m m t n t a s eyen 16) e o e state.
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(6) Piace of Deat: CTick the appropriste box from enties 0 e e e 1 z o \ 1 2 3 b e l o w a n d % B I _ u n _ q a ?
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a s g i s a e 1414 11 do<an v o wcman, s t the i o<t uring ragaancy 3 the Gme of dekvery or within | week aftet delivery.
[ T — - f y e s D w e [ 15 ackicted 10 smoking, for how many years?
(16} Hf acclicted to tobscco in any form. for how many yeers?
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b Regication Date — — — — e - Remata Gfany) T B y A e mogietontem * r r y e — iSee Rule 5) £ 8 (SeeRules) Lagal Fert - S m a e t h i mation s e mmiscalpare (AR ragistzaion, this legal 5wt will b called Forie Number| = % (See Rule 12) (See Rule 12) .
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o Form No. 4 (See Rule 7) Medical certifidate of cauise of death (not to ba filled in for hospital inpatients, stillbirths) To be sent tG the Registrar along with Forfm 2 (Death Report).
hospital name 1 certify that the person whose particulars are given below died in Ward No... of the hospital .datedin...
..at am/pm. iraodock.
N ot e et - » age at death . ) For the uae of statmveal — i office Fone yearormore, | If less than one year, Wiess thanore morh, wrae 1 nm,-ul-a,m-ua.,}‘ = age in years writa the age in months. the age in days. write,the age in hours,
1. men . 0 ' 2 woman. > .
The interval between onset of | cause of death P ]
(1) Immediate cause:- K).
Mention the disease, injury or complication that causedthe due to {or as a result of) death. Do not mention how the deathoccumred, ie., due to cardiac arrest, debility, etc. '_ Previous reasons:- ®) Unhealthy condition, if any csusng te above mentioned ressons md(«u-m{tm and thefinslunderlymg condiion M@ ntion.- @ Qther significant conditions that contributed 1o the death but are not et 1o the daanve or conditon hat caused the desth typos of death i it —reea st
(1) natural (2) occident - (3) suicide (0 Mhsder by bumans 1) msaaen pending ¥the decessed was fomie, wa1 the daath suted 0 pregnancy? yes dd dekvor y occur M yes ) fio mYes (2)no ) Name and signature of the medical attendant certifying the cause of death verification date RS 5 Sew back page for instructons S a0d givato the relative of the deceased) It is certified that Shri/Smt/Kumari 5 : SoDoughterWts ot S :
Residont date if‘ thishospital _______To was admitted and the date of his death Hashappened doctor + - Name of Medical Hospital) Form No. 4 "A" ' (See Rule 7) Medical certificate of cause of death (do not use for oug-of—insflmtion deaths, stillbirths) to be sent to the Registrar along with Form 2 (Death Report).
I hereby certify that the deceased Shri/Smt/Kumari...
sorvwdaidsughes g R N Y e oa N . . date. 1 bt T Bt ‘washeas e hisher ot of death trom T————— e ONAM/PM ____ tillnow. e roid L age at death For the use of .
statistical offics full years of age 1f less than one year, W less Than ané month, wiite the | IF the age is one’ L e st ageindays g el i g s
1. man 2 woman cause of death The serval twoen oret . PO, (1) Immediate cause:~ X Mention the disease, ifjury or complication that caused due to {or as a result of) the death. Do not mention how the death occurred, ie., due to cardiac arrest, debility, etc.
oy () State the unhealthy condition, if any, which gave rise to the above because of (or as a result of) cause and the ultimate underlying condition.
@ @ Other significant conditions that contributed to the death but are e 0t related ta the dissese or condition thit caused the death.
A1 % u-mm_nm,nmmwufinmmmamm (1) yes (2) no
(1) Yes(2) No 2 s X t Name and signature of the { x mettical attendan certitying the case of e vien See back page for instructions.
(Yo be given sepdrately (o the relative of the ‘ docensed) 1 hereby cortiy that the docessed SHr/SMU/KUMAN .- oo, OCCMSION__at = . e Al wismcnen QN AMIPM... i Medical certificate of the cause of death Instructions to fill the form Name of the deceased: Write the full name. Do not use initials. If the deceased i is aninfant and has not yet been named, write the mother’s and father's names before ~son of* or “daughter of."
Age: If the deceased is more than one year old, write the age in completed years. if less than one year old, write the age in months, and if less than one day, write the age in hours.
Cause of deathi This part of the form shouid always be filedn by the medical attendant himself. :
. The certificate of cause of death is divided into two parts, Part | and Part lil.
Part | is further divided into three parts, namely !ines (a), (b) and (c). If the 'cause of death is clear from a pathological condition, it will be w;rfien in line g
(a) of Part | and nothing else will be required in Part | or Part Ii, For example, smallpox, polio, pneumonia, heart disease, beriberi, etc. are sufficient causes of v, death and usually no further menticn will be required.
However, often, several underlying conditions may be present at the time of 5 death, and the physician must then complote the certificate aps;mprialdy o dekarmiveiha true undsr;ying cause First, r;cord the-uctual cause of deathin Pafi I.(;). This has no bflmng on the mar;nar of death, i.e., cardiac arrest, re%piratory ana;t, etc: These'should ;
not be listed on the certificatejatal ¢ cause.
cause online (b) in Prt 1, Sometimes, there are th ree sequences of events leading to death. If this is the case, line (c) should be complete d. The underlying cause to be tabulated should be written at the end of the se ction.
There may be underlying conditions or i njuries which are not directly connected with the course of events wh ich caused the death, but which in som e way contribute o the fatal outcome. Sometimes i is difficu l for the physician to decide, especially in cases of infant deaths, which of several separate con ditions is the main cause of death, but only one cause has fo be given. The refore, the physician must determi ne the cause. If other diseases are not a consequence of the underlying cause, they wil be r ecorded in Partl.
Do not write two or more reasons on t he same line. Please write the names o f the diseasesin the certiicatein fulland clearly to avoid any possible readin g errors.
Commencement: Wherever possible, fillin the interval between commence ment and death, evenf itis approximat . such as "from birth" o by years', Death due to accident or violence: Both the ext ernal cause of injury and the nature of the injury are essential and mu st be described. The physician o hospital should describe the injury. The part of the body a ffected must be described, and ifindicated, the external cause must be fully stated. Examples: (a) hypostatic emmsmnaia. ) frantirs af tha famie () fall from a stai rcase athome.
o Maternal Mortality: Be sure to answer questions about pregnancy and al tal y: Be s nswe pregl childbirth, This information is required for all women of c hildbearing age, even if the pregnancy s ot gt 10 e oot Old age or senility: If a more specific cause is known, then old age (or 0ld age should not be stated as the cause of death. If old age is a contributing factor, it should be mentioned in Part Il.
Examples: (a) Chronic bronchitis, Il-old age.
Completeness of information: A complete patient history is not required, but if information is available, sufficient detail should be given to properly classify the underlying cause.
Examplé: Anemia - If known, state the type of anemia, Whenever possible Neoplasm - Indicate whether benign or malignant énd its location, including the site of the primary neoplasm. Heart disease - Describe the condition spocnfically If cardiac arrest is due to congestion, mention chronic or pulrnonary, etc.
Describe previous conditions. Tetanus - If known, describe the previous - organs, injury. Write the cause of the operation. Diarrhea (dysentery) - If known, spaclfy whether itis vaceinal or amoebic, etc, CQmphcatlons of pregnancy or childbirth - - Describe the oumphcation Tuberculosis (TB) Name the affected 3ymptomnflc natdmbm: Craimps, dysentery, fever, ascites, ]aundloe. weakneu.
otc. are symptoms that may be present due to 8ny one of several different conditions. Sometimes o Nothing more is known, but whenever possible, name the disease that caused the symptom.
Type of death:- If death is without any cause then it is called natural (i normal) death.
If the cause of death is known but it is not known whether the death is due to accident, suicide or homicide and it is a subject of further investigation, the cause of death should be entered as invariable and the manner of death should be shown as “Pending investigation”.
e ey 6 Form No. 5 , (See Rule 5) birth certificate (issued under sections 12 and 17) | certify that the following information has been taken from the original ... ofthe ..
i C focal of the Tehsd — of theStataot ...
P birth record ____.....
i L ool :
Name " o = e :
, dwto of birth PR T T e place ol birth mrs s A A essma e 8 ‘Father's name £ Hr s mother's name b SRR o T ac o ol i registration number - o date of registration Date:~ .
signature of the issuing authority LT | D—— Form No. 6 (See Rule 5) Death certificate (issued under sections 12 and 17) I certify that the following information has been taken from the original death sk St recard register of the local . the Tehsi of the Name.
Fatherusband's name gende:
place of death registration number date of registration . ........cceecempssiisnsnarenssnsesen s enansessnas — — Date:- Signature of the issuing authority™ seal. eeeee aeneas sezsmenensanasenarcsatess Particulars regarding the cause of death, as they are recorded in the register, shall not bé disclosed (see proviso to section 17(1)). ™% Form No. 10 (See rule 13) ) 8 non-availebility certificate (Issued under Section 17 of the Registration of Births and Deaths Act, 1969) asssrssenfarareninenne On the request of Shri, » . (local area) ... (Tehsil) (District) 4 search was conducted - | certify that Shri/Smt/Kumari sonmifeldaughter .., iuuracmeneeannrasrarsen in the registration records of (State) for the yearfyears and it was found that ...ccccceviieeinrsensans evseresessesnsssnassassssasesssssmssssiesnerenss " THE birth/death event ha¥TST Been registered. sonmwilotiagher S ., Date ;- :
B Form No. 11 (See rule 14) Summary of Monthly Report of Births (‘) vk . annual report
(2)District..
(3) Town/village {4) Registered unit.
(5) Number of registered births.
(a) within one year of birth !
(b) after one year of birth:
Total: (a+b) The total should be aqual to the number in the statistical section of the Bith Report Form (Form No. 1) attached to this monthly report Date: Name and signature of the Regisurar Submitted o the Chied Registrar Dstrict Regisarar Form No. 12 (See rule 14) Summary of MonthK} Death Report
(0) i Y, 2 annual report 12) Dwtrict. ¥ .
(3) Townnillage
(4) Registered unit. »
(5) Detalls of deaths rogistered during the month:- : .
gl e ettt matemai death Registered within one year one year after death of gl repstared ! c 3 4 s Date: ’ Narme and signature of the Reghres Note: Infant and maternal deaths should also be included in deaths.
« Total- should be equal to the numbar of the statistical part of the death report (Farm Ng: 2) attached to this monthly report, Form No. 13 (See rule 14) (Summary of Monthly Stillbirth Report) o Y annual report st (3 Towwillage - #
(4) Number of registered bisths.
(8) Number of stllbirths registered * Date:
Name and signature of the Registrer ) The number of sillirths registered should be equal o the number of Stillbirth Report Forms (Form No. 3) enclosed - ‘with this monthly regort. p :
‘Submited to the Chiof RegstrarDistrict Reglstror