| Cost of Form Rs 10/- |
| To, |
| The Cantonment Executive Officer, Bareilly Cantonment Board. |
| SUBJECT : APPLICATION FOR OBTAINING THE BIRTH CERTIFICATE |
|---|
| Sir/ Madam, |
With due regards it is submitted that my wife named Smt........................................has given a birth to a male child / female child on dated........................in military Hospital / Cantonment General Hospital of Premises (H.No.)..................................Within Cantonment Area. |
| APPLICANT |
| Date :-............................. Name :-.......................... |
| Verification of respected person |
| 1. |
| 2. |
| FOR OFFICE USE ONLY |
| Name of Applicant...............................................................Fee Rs............................... |
| Deposited vide Receipt No..................................................Dated.................................. |
| Concerned Clerk |