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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