Form Thor - Royal Thai Consulate-General, Vancouver
[pic] 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
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