"Birth Certificate Application Form" - Guyana

This "Birth Certificate Application Form" is a part of the paperwork released by the Guyana Department of Public Information specifically for Guyana residents.

The latest fillable version of the document was released on January 1, 1986 and can be downloaded through the link below or found through the department's forms library.

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B
ACCESSION/
FILE NO.
BIRTH CERTIFICATE APPLICATION FORM
B
CERT. NO.
General Register Office - Government of Guyana
DO NOT WRITE IN SHADED AREAS ON THIS FORM – WRITE ALL INFORMATION CLEARLY IN INK – IN SECTIONS 1 TO 8 PROVIDED ALL INFORMATION ABOUT THE
PERSON FOR WHOM THE BIRTH CERTIFICATE IS TO BE ISSUED.
4
DATE OF
1
NS
LAST NAME
BIRTH
(SURNAME)
DAY
MONTH
YEAR
OS
5
SEX
2
FIRST NAME
MALE
FEMALE
3
OTHER NAMES
HOSPITAL
6
PLACE
OF
NAME OF HOSPITAL OR INSTITUTION
LOCATION
REGION
BIRTH
OTHER
NUMBER
STREET OR DAM
WARD OR VILLAGE
TOWN OR COUNTY
REGION
7
MOTHER’S
MAIDEN NAME
LAST NAME
FIRST NAME
OTHER NAMES
8
FATHER’S
NAME
LAST NAME
FIRST NAME
OTHER NAMES
9
NAME AND ADDRESS TO
WHICH CERTIFICATE IS TO BE
SENT
NAME
ADDRESS
10
POST OFFICE
USE ONLY
TRANSMITTAL NO.
POST OFFICE
DATE RECV.
ITEM NO.
RECEIPT NO.
NO. COPIES
INITIAL
11
RECV.
OPER.
TRANS.
DESP.
ADV
H
P
H
P
H
P
H
P
CLK
AFFIX
GRO USE ONLY
POSTAGE STAMP
DI
HERE
DO
IC
ANE
TD
ENT
DES
CERT
NOT
RMK
Systems Design Under Contract Guyana Management Institute, 1986
B
ACCESSION/
FILE NO.
BIRTH CERTIFICATE APPLICATION FORM
B
CERT. NO.
General Register Office - Government of Guyana
DO NOT WRITE IN SHADED AREAS ON THIS FORM – WRITE ALL INFORMATION CLEARLY IN INK – IN SECTIONS 1 TO 8 PROVIDED ALL INFORMATION ABOUT THE
PERSON FOR WHOM THE BIRTH CERTIFICATE IS TO BE ISSUED.
4
DATE OF
1
NS
LAST NAME
BIRTH
(SURNAME)
DAY
MONTH
YEAR
OS
5
SEX
2
FIRST NAME
MALE
FEMALE
3
OTHER NAMES
HOSPITAL
6
PLACE
OF
NAME OF HOSPITAL OR INSTITUTION
LOCATION
REGION
BIRTH
OTHER
NUMBER
STREET OR DAM
WARD OR VILLAGE
TOWN OR COUNTY
REGION
7
MOTHER’S
MAIDEN NAME
LAST NAME
FIRST NAME
OTHER NAMES
8
FATHER’S
NAME
LAST NAME
FIRST NAME
OTHER NAMES
9
NAME AND ADDRESS TO
WHICH CERTIFICATE IS TO BE
SENT
NAME
ADDRESS
10
POST OFFICE
USE ONLY
TRANSMITTAL NO.
POST OFFICE
DATE RECV.
ITEM NO.
RECEIPT NO.
NO. COPIES
INITIAL
11
RECV.
OPER.
TRANS.
DESP.
ADV
H
P
H
P
H
P
H
P
CLK
AFFIX
GRO USE ONLY
POSTAGE STAMP
DI
HERE
DO
IC
ANE
TD
ENT
DES
CERT
NOT
RMK
Systems Design Under Contract Guyana Management Institute, 1986
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