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(Translation)

Form Thor.Ror.19
Part 4

CERTIFICATE OF BIRTH
No.

This is to certify that


Notification of birth has been acknowledged for the birth of :

Name : ... Surname :


Sex : .. Nationality : Date of birth :
Month : .. Year : At : .. hrs.
Corresponding to the day : Waxing Moon / Waning Moon :
Lunar Month : ... The Year :
House No. : Road : .. Lane : ..
Alley : . Village No. : .
Sub-district : . District :
Province : ...
Mother's Name : .. Age : .. years
Mother's Nationality : ...
Father's Name : Age : .. years
Father's Nationality :
May this child be blessed with happiness and prosperity.
Given on Day .. Month Year
At Registration Office : .
Signed : .
Position of Registrar :
Remarks : 1. This certificate is an important document and should be kept as evidence.
2. The new born must be named within 6 months from the date of birth and
this certificate must be presented to the Registrar Acknowledging Birth.
Certified correct translation