COMMITTEE Commune/ward: .... CERTIFICATE OF BIRTH Full name: .... Native village: .... Full name of declarant: .... RRelationship with declarant: .... DECLARANT Signed Civil StatusJudici
Trang 1COMMITTEE
Commune/ward:
District:
Province/City:
SOCIALIST REPUBLIC OF VIETNAM Independence- Freedom- Happiness
- BTP/HT-12345-KS.2 No:
Book:
CERTIFICATE OF BIRTH Full name:
Sex:
Date of birth: In words:
Place of birth:
Ethnic group:
Nationality:
Native village:
Full name of father:
Ethnic group:
Nationality:
Full name of mother:
Ethnic group:
Nationality:
Full name of declarant:
RRelationship with declarant:
DECLARANT (Signed) Civil StatusJudicial Officials (Signed) Dated
Instate People’s Committee
PP CHAIRMAN
(Signed and sealed)