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KHIDMAH HOSPITAL (PVT.) LTD. & DIAGNOSTIC CENTER

C-287/2-3, Khilgaon Bishwa Road, Dhaka-1219, Bangladesh
Phone: 880-2-7210749 (Hunting), Mobile: 01711063030
Fax: 880-2-8250753, E-mail: info@khidmahhospital.com, www. khidmahhospital.com

Birth Certificate
Registration No. 0027 7

Name of the Baby: .......................................................................................... Sex :

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Mother’s Name:
.................................................................................................................................................

Father’s Name:
...................................................................................................................................................

Address: .................................................................. P.O.:

..................................................................................

P. S.: ........................................................................ District:

...........................................................................

Date of Birth: ..................................................... Time of Birth:

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Baby Weighted: .................................................. Kg. at Birth.

Date: .................................................... Signature& Seal