[Superior right corner: Emblem of Peru]

[Superior left corner: RENIEC-CIVIL NATIONAL

REGISTRATION OF IDENTIFICATION AND CIVIL STATUS-
emblem]

[Right: Certificate No. 80964213]

CIVIL NATIONAL REGISTRATION OF IDENTIFICATION AND CIVIL STATUS

CERTIFICATE OF BIRTH

UIC No. 80964213

DATE OF BIRTH HOUR

DATE/ MONTH / YEAR AM/ PM

PLACE OF BIRTH
1. Hospital. 2. Clinic. 3. Health Centre. 4. House. 5. Other

UBG. DEPARTAMENT UBG. PROVINCE

UBG. DISTRICT UBG. CENTRE SETTLEMENT/ NATIVE OR PEASANT COMMUNITY

SEX 1.Male
2.Female

CERTIFIER

Given names

First surname

Second surname

FATHER

Given names

First surname

Second surname

Identification document: 1. ID; 2. MP1/Bol; 3. EC; 4. Other No. Nationality 1.Peruvian

2. Foreigner
MOTHER

Given names

First surname

Second surname

Identification document: 1. ID; 2. MP/Bol; 3. EC; 4. Other No. Nationality 1.Peruvian

2.Foreigner
ADRESS

UBG. DEPARTAMENT UBG. PROVINCE

UBG. DISTRICT UBG. CENTRE SETTLEMENT/ NATIVE OR PEASANT COMMUNITY

DATE OF REGISTRATION
DATE/ MONTH / YEAR

REGISTRATION OFFICE

UBG. DEPARTAMENT UBG. PROVINCE

UBG. DISTRICT UBG. CENTRE SETTLEMENT/ NATIVE OR PEASANT COMMUNITY

DECLARANT: BOND: Identification document: 1. ID; 2. MP/Bol; 3. EC; 4. Other No.

Given names

First surname

Second surname

DECLARANT: BOND: Identification document: 1. ID; 2. MP/Bol; 3. EC; 4. Other No.

Given names

First surname

Second surname

CIVIL REGISTRAR
First surname Second surname Given names

ID

NOTES:

Declarants signature Declarants signature Registrar signature and seal

[Fingerprint-Right index finger] [Fingerprint-Right index finger] [Fingerprint-Right index finger]

Glossary

WORD GENRE DEFINITION TRANSLATION DEFINITION SOURCE

Es todo lugar del territorio Every national Peruvian
nacional (peruano) identificado territory identified with a
mediante un nombre y habitado name and inhabited
Centro Loc. Centre
con nimo de permanencia, por permanently by many (1)
poblado nom settlement
lo general, por varias familias o, families or, in exceptional
por excepcin, por una sola cases, by one family or
familia o una sola persona. person.
Instituciones histricas, Historical institutions
reconocidas en el artculo 89 de recognized in the 89th article
la Constitucin Poltica del Per. of the Constitucin Poltica
Se compone de grupos de del Per (Peruvian
Comunidad Native or
Loc. personas cuyo origen se Constitution). It is composed
Nativa o peasant (2)
nom encuentra en los pueblos of a group of people that has
Campesina community
originarios o pueblos indgenas its origin in the native
que poblaron por primera vez el villages that populated the
territorio peruano. Peruvian territory by first
time.
Cdigo nico de Identificacin Unique identification Code
CUI initials UIC (3)

nica cdula de identidad Only identification document

emitida a ciudadanos peruanos emitted to major and minor
Documento
Loc. mayores y menores de edad, Identificatio aged Peruvian citizens,
Nacional de (4)
nom siendo el nico ttulo de derecho n Document which allows people older
identidad
al sufragio para los mayores de than 18 years with the right
18 aos. to vote.
Documento que acredita la Document that accredits
LM (Libreta situacin militar y se otorga slo MP (Military military state only given to
initials (5)
Militar) a quienes presenten el Servicio Passbook) those enrolled in the Military
Militar. Service
Centro Asistencial ambulatorio, Ambulatory Assistance
Posta Health
n. que presta atencin primaria de Centre, which provides (6)
(mdica) Centre
salud. primary health services.

1. INEI (2017) Disponible en:

www.proyectos.inei.gob.pe/web/biblioineipub/bancopub/Est/Lib0017/ANEX2.htm
2. Parthenon (2017) Qu son las Comunidades Campesinas y Nativas? Una perspectiva Jurdica. Disponible en
www.parthenon.pe/mas/que-son-las-comunidades-campesinas-y-nativas-una-perspectiva-juridica/
3. RENIEC (2017) DNI/Documento Nacional de Identidad. Disponible en:
www.reniec.gob.pe/portal/acercaDni.htm#
4. Trmite Per (2017) Libreta militar. Disponible en: www.tramiteperu.com/libreta-militar/
5. EsSalud (2008) Manual Institucional. Disponible en:
www.essalud.gob.pe/defensoria/manual_institucional.pdf