FEDERAL REPUBLIC OF NIGERIA

NATIONAL POPULATION COMMISION

Certificate of Birth A16_34 03235633

Issued under the births and Deaths Etc. (Compulsory Registration) Decree No 89 of 2943

Registration Centre:
_________________________
Town/Village: _____________________________
______|_______|______
L.G.A: ___________________________________
Volume Year Entry No.
State: ____________________________________

This is certified that the birth details of which are recorded herein has registered on
______|_______|______
At registration centre: ____________________________
Day Month Year

1. Full Name: _______________________________________________________________

2. Sex: ______________________ 3. Date of Birth: ______ _______ ______

Day Month Year

4. Place of Birth: _____________________ Town/Village: ___________________________

5. Full Name of Father: ________________________________________________________

6. Full Name of Mother: _______________________________________________________

Place of issue: _____________________

Name of Registrar
Date: ____________________________
Sign of Registrar