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W*GG* BIRTH CERTIFICATE TRANSCRIPTION FORM

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ORIGIN of CERTIFICATE - COUNTRY & / or STATE          


Please enter the details EXACTLY as they appear on the Certificate
REGISTRATION DISTRICT  
YEAR  
BIRTH in the Sub-District of  
in the  
No.  
When and where born  
Name, if any  
Sex  
Name and surname of father  
Name, surname and maiden surname of mother  
Rank or profession of father  
Signature, description and residence of informant  
When registered  
Signature of registrar  
Name entered after registration  

Other comments or information



Submitter's Name
Submitter's E-mail
Source of information

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© 2002  Vivian Egan This page was last modified
11 September 2003
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