ADMINISTRATION OF THE UNION TERRITORY OF LADAKH

HOUSING AND URBAN DEVELOPMENT DEPARTMENT

Application Form for Birth Certificate

USER GUIDANCE HELP DOCUMENT

Local Body Details

Which District are you located? *

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Applicant Details

Who is Applying? *

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Name of Applicant *

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Mobile Number *

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E-Mail *

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Birth Details

Is the age of child is more than 5 years? *

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Name of Child * THE PERSON WHO WILL BE ENTILED BY BIRTH CERTIFICATE

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Father's Name *

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Mother's Name *

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Gender *

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MALE

FEMALE

TRANSGENDER

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Date of Birth of Child (Kindly apply after 15-20 days of event ) *

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Date of Birth (In words) *

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Place of Birth *

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Hospital is Located at *

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Specify Place of Birth ( If Others ) *

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Name of Government Hospital * Please Select which District are you located first

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Address of Parents at the time of Birth of Child *

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Permanent Address of Parents *

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Declaration

I do hereby declare that the information given above and in the enclosed documents is true to the best of my knowledge and belief and nothing has been concealed therein. I am well aware of the fact that if the information given by me proved false/not true at any point of time, I will have to face punishment as per any provision of law for the time being in force as well as the certificate obtained by me shall be summarily cancelled.

Special Note : Only clear coloured scanned copies of the original documents will be accepted. B/W photocopies will not be accepted. The process will take 2-10 working days.

I Agree *

(Certificate Fees Rs.200/-)

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