Published vide Notification Nagaland Gazette, Extraordinary No. 7, dated 24th June, 1972
ner159
- Short title, extent and commencement.- (1) These Rules may be called the Nagaland Registration of Births and Deaths Rules, 1972.
(2) These rules extend to the whole State of Nagaland.
(3) These rules shall come into force on 1st July, 1972.
- Definitions.- In these rules, unless the context otherwise requires-
(a) "Act" means the Registration of Births and Deaths Act, 1969;
(b) "Form" means a Form appended to these rules; and
(c) "Section" means a section of the Act.
- Period of gestation under Section 2(1)(g).- The period of gestation for the purposes of Clause (g) of sub-section (1) of Section 2 shall be twenty-eight weeks.
- Submission of report under Section 4(4).- The report under sub-section (4) of Section 4 shall be prepared in Form No. 1 and shall be submitted along with the statistical report referred to in sub-section (2) of Section 19, to the State Government by the Chief Registrar every year by the 31st July of the year following the year to which the report relates.
- Form etc., for giving information of births and deaths a under Sections 8 and 9.- (1) The informations required to be given to the Registrar under Section 8 or, as the case may be, Section 9, shall, if given in writing, be in Form Nos. 2, 3 and 4 for the registration of birth, still birth and death respectively, and if given orally, mention the several particulars in the relevant Form.
(2) The information referred to in sub-rule (1) shall be given-
(a) in a municipality town with clearly demarcated boundary and having a separate local administration, or a cantonment-
(i) within seven days from the date of birth or still birth; and
(ii) within three days from the late of death;
(b) in any other area-
(i) within fourteen days from the date of birth or still birth; and
(ii) within seven days from date of death.
- Birth or death in a vehicle under Section 8 (1)(f).- (1) In respect of a birth or death in a moving vehicle, the person in-charge of the vehicle shall give or cause to be given the information under sub-section (1) of Section 8 at the first place of halt.
Explanation. - For the purpose of this rule, the term "vehicle" means conveyance of any kind used on land, air or water and includes an aircraft, a boat, a ship, a railway carriage, a motor-car, a motor cycle, a cart, a tonga and a rickshaw.
(2) In the case of deaths [not falling under Clauses (a) to (e) of sub-section (1) of Section 8] in which an inquest is held, the officer who conducts the inquest shall give or cause to be given the information under sub-section (1) of Section 8.
- Time and Forms for notifying information under Section 10(1).- (1) Every person required to notify a birth, still birth or death under Section 10 shall give information thereof to the Registrar in Form No. 5, 6 or 7 as the case may be.
(2) Such information shall be given-
(a) in a municipality town with clearly demarcated boundary and having a separate local administration or a cantonment-
(i) within seven days from the date of birth or still birth; and
(ii) within three days from the date of death;
(b) in any other area-
(i) within fourteen days from the date of birth or still birth; and
(ii) within seven days from the date of death.
- Form of certificate under Section 10(3).- The certificate as to the cause of death required under sub-section (3) of Section 10 shall be issued in Form No. 8 and the Registrar shall, after making necessary entries in the register of births and deaths, forward all such certificates to the Chief Registrar or an officer specified by him in this behalf by the 10th of the month following the month to which the certificate relate.
- Extracts of registration entries to be given under Section 12.- The extracts of particulars from the register relating to births and deaths to be given to an informant under Section 12 shall be in Form No. 9 or in Form No. 10, as the case may be.
- Authority for delayed registration and fee payable thereof under Section 13.- (1) Any birth or death of which information is given to the Registrar after the expiry of the period specified in Rule 5, but within thirty days of its occurrence, shall be registered on payment of a late fee of rupees one
(2) Any birth or death of which information is given to the Registrar after thirty days, but within one year of its occurrence, shall be registered only with the written permeation of the officer prescribed in this behalf and on payment of late fee of rupees three and on production of the affidavit made before a notary public or any other officer authorised in this behalf.
(3) Any birth or death which has not been registered within one year of its occurrence, shall be registered only on an order of a Magistrate of the first class or a Presidency Magistrate and on payment of a late fee of rupees five.
- Period for the purpose of Section 14.- (1) Where the birth of any had been registered without a name the parent or guardian of such child , within 12 months from the date of registration of the birth of child, give information regarding the name of the child to the Registrar either orally or in writing:
Provided that if any such information is given after the period of 12 months, subject to the provisions of sub-section (4) of Section 23, the Registrar shall-
(a) if the register is in his possession, forthwith enter the name in the register on payment of a late fee of rupees two ;
(b) if the register is not in his possession and if the information is given orally make a report giving necessary particulars, and if the information is given in writing, forward the same to the officer specified by the State Government in this behalf for making the necessary entry on payment of a late fee of rupee two.
(2) The parent or the guardian, as the case may be, shall also present to the Registrar the copy of the extract given to him under Section 12 or a certified extract issued to him under Section 17 and on such presentation, the Registrar shall make the necessary endorsement relating to the name of the child or take as laid down in Clause (b) of the proviso to sub-rule (1).
- Correction or cancellation of entry in the register of births and deaths Section 15.- (1) If it is reported to the Registrar that a clerical or formal has been made in the register or if such error is otherwise noticed by him the register is in his possession, the Registrar shall enquire into the matter he is satisfied that any such error has been made, he shall correct the entry by correcting or cancelling the entry) as provided in Section 15 and shall send an of the entry showing the error and how it has been corrected to the State ament or the officer specified by it in this behalf.
(2) In the case referred to in sub-rule (1) if the register is not in his possession, the Registrar shall make a report to the State Government or the specified by it in this behalf and call for relevant register and after enquiring into the matter, if he is satisfied that any such error has been made, he necessary correction.
(3) Any such correction as mentioned in sub-rule (2) shall be counter-signed by the State Government or the officer specified by it in this when the register is received from the Registrar.
(4) If any person asserts that any entry in the register of births and deaths is erroneous in substance, the Registrar may, correct the entry in the manner bed under Section 15 upon production by that person a declaration setting re nature of the error and true facts of the case made by two credible 5 having knowledge of the fats of the case.
(5) Notwithstanding anything contained in sub-rule (3) and sub-rule (4), the registrar shall make report of the correction of the kind referred to therein necessary details to the State Government or the officer specified in this
(6) If it is proved to the satisfaction of the Registrar that any entry in the of births and deaths has been fraudulently or improperly made, he shall i report giving necessary details to the officer authorised by the Chief Registrar by general or special orders in this behalf under Section 25 and the Registrar, on hearing from him, take necessary action in the matter.
(7) In every case in which an entry is corrected or cancelled under this rule, intimation thereof should be sent to the permanent address of the person who has given information under Section 8 or Section 9.
- Form of register under Section 16.- (1) The register of births, still births and deaths to be kept by the Registrar under Section 16 shall be in three parts as set forth in Form Nos. 11, 12 and 13 respectively and in each part of the register, the event shall be numbered serially and for each calendar year.
(2) A new register shall be opened on the first day of January of each year.
(3) Any event which occurred in any previous, year shall be recorded in the register for the year in which it is reported :
Provided that no entry shall be interpolated between two entries recorded earlier.
- Fees and postal charges payable under Section 17.- (1) The fees payable for a search to be made or an extract to be issued under Section 17 shall be as follows;
| Rs. P. | ||
| (a) | search for a single entry in the first year for which the search is made | 1.00 |
| (b) | for every additional year for which the search is continued | 1.00 |
| (c) | for granting extract relating to each birth or death | 1.00 |
(2) Any such extract in regard to a birth or death shall be issued by the Registrar or the officer authorised by the State Government in this behalf in Form No. 9 or, as the case may be, Form No. 10 and shall be certified in the manner provided for in Section 76 of the Indian Evidence Act, 1872 (1 of 1872).
(3) Any such extract may be furnished to the person asking for it by post on payment of the postal charges therefor.
- Interval and forms of periodical returns under Section 19(1).- (1) Every Registrar, including the Registrar for a Municipality with a population less than shall send to the Chief Registrar or the officer specified by him in this behalf on or before the 5th day of each month, a true copy of the entries in the register of births and deaths relating to the month immediately preceding.
(2) The officer so specified shall forward all such copies of the entries in the register of births and deaths received by him to the Chief Registrar not later than the 10th of that month. He shall also send at the same time a report showing the names of the specified areas within his jurisdiction to which the birth and death entries relate (including those areas where no birth or death has occurred) along with the number of births and deaths registered in each.
(3) The Registrar for a Municipality with a population more than................shall send to the Chief Registrar in Form No. 14 a weekly return of births and deaths within 7 days of the expiry of the week to which the information relates, and in Form No. 15 a monthly return of births and deaths by the end of the month following the month to which the information relates.
(4) The Registrar for Cantonment shall send to the Chief Registrar or the officer specified by the Chief Registrar in this behalf, a weekly return of births and deaths in Form No. 14 within 4 days of the expiry of the week to which the information relates and a monthly return of births and deaths in Form No. 15 by the end of the month following the month to which the information relates.
- Statistical report under Section 19(2).- The statistical report under sub-section (2) of Section 19 shall be in Form No. 16 and shall be complied with for each year before the 31st July of the year immediately following and shall be published as soon as may be thereafter but in any case not later than five months from that date.
- Conditions for compounding of offences under Section 23.- (1) Any offence punishable under Section 23 may, either before or after the institution of original proceedings under this Act, be compounded by an officer authorised by the Chief Registrar by general or special order in this behalf; if the officer so authorised is satisfied that the offence was committed through inadvertence or oversight or for the first time may be executed with warning.
(2) Any such offence may be compounded on payment of such sum not exceeding rupees fifty for offences under sub-sections (1), (2) and (3), and rupees ten for offences, under sub-section (4) of Section 23 as the said officer may think fit.
- Registers and other records under Section 30(2)(k).- (1) The register of births and deaths shall be a record of permanent importance and shall not be destroyed.
(2) All information received by the Registrar under Sections 8 and 9 and the certificate as to the cause of death furnished under sub-section (3) of Section 10 of the Act shall form an integral part of the Register of Births and Deaths and shall not be destroyed.
(3) Every Register of Births and Deaths and the forms relating to the entries therein shall be retained by the Registrar in his possession for a period of twelve months after the end of the calendar year to which it relates and such registers and forms shall thereafter be transferred for safe custody to such office r as may be specified by the State Government in this behalf.
- All fees payable under the Act may be paid in cash or by money order or postal order.
Form 1
[See Rule 4]
Report on the working of the Act
- Brief description of State, its boundaries and revenue districts
- Changes in administrative areas
- Explanation about the difference in areas
- Changes in Registration Area-extension
- Administrative set up of the registration machinery at various levels
- General response of the public towards this Act.
- Notification of births and deaths
- Progress in the medical certification of cause of death
- Maintenance of records
- Search of births and deaths register for issue of certificates
- Delayed registrations
- Prosecutions and compounding of offences
- Difficulties encountered in implementation of there Act-
(i) Administrative
(ii) Others
- Orders and instructions issued under the Act
- General remarks
Form 2
[See Rule 5]
Live Birth Report
Serial No.......
Registration Unit/Village/Town/Municipality/Taluk/Tahsil/Block/Thana................District................
- Date of birth......
- Sex : male/female........
- Name of child.........
- Place of birth.....
- Permanent residential address..........
- Father's-
(i) Name..........
(ii) Literacy.....
(iii) Occupation.........
(iv) Nationality
(v) Whether SC/ST*
(vi) Religion
- Mother's-
(i) Name.....
(ii) Literacy.....
(iii) Occupation.........
(iv) Nationality (vi) Religion
(v) Whether SC/ST*
- Age of mother in completed years at confinement
- Order of birth (Number of live births including the births registered)
- Type of attention at delivery
- Informant's-
(i) Name
(ii) Address
Date
Signature or left thumb mark of the informant
Note. - If the person is a non-worker, insert the word Nil in the column for occupation.
*Certificate from the competent authority to be attached.
SC-Scheduled Caste.
ST-Scheduled Tribe.
Form 3
[See Rule 5]
Still Birth Report
Serial No.....
Registration Unit/Village/Town/Municipality/Taluk/Tahsil/Block/ Thana...................District
- Date of birth......
- Sex : male/female .....
- Place of birth.....
- Permanent residential address of parent........
- Father's-
(i) Name.........
(ii) Literacy....
(iii) Occupation......
(iv) Nationality
(v) Whether SC/ST*
(vi) Religion
- Mother's-
(i) Name.....
(ii) Literacy....
(iii) Occupation......
(iv) Nationality
(v) Whether SC/ST*
(vi) Religion
- Age of mother in completed years at confinement
- Type of attention at delivery
- Informant's-
(i) Name
(ii) Address
Date
Signature or left thumb mark of the informant
Note. - If the person is a non-worker, insert the word Nil in the column for occupation.
*Certificate from the competent authority to be attached.
SC-Scheduled Caste.
ST-Scheduled Tribe.
Form 4
[See Rule 5]
Death Report
Serial No......
Registration Unit/Village/Town/Municipality/Cantonment/Taluk/Tahsil/Block/Thana/District.
- Date of death
- Full name of the deceased
- Name of the father/husband
- Place of death
- Age
- Sex : male/female
- Marital status
8 Occupation
- Religion
- Nationality
- Permanent residential address
- *Cause of death
- Whether medically certified (Yes/No)
- Kind of medical attention received, if any
- Whether SC/ST†
- Informant's-
(i) Name
(ii) Address
Date.
Signature or left thumb mark of the informant
*Where the cause of death is medically certified the cause marked ( ) in the medical certificate Form No. 8 is to be entered here.
Note. - If the person is non-worker, insert the word Nil in the column for occupation.
†Certificate from the competent authority to be attached.
SC-Scheduled Caste
ST-Scheduled Tribe.
Form 5
[See Rule 7]
Notification Form for a Birth
| Date of birth | Sex of the child | Place of birth (with full address) | Name and local address of parent |
| (1) | (2) | (3) | (4) |
Signature of the person notifying Name and Designation Date. ..............
For the use of Registration Office-
(a) Whether registered or not;
(b) If-
'Yes' (i) annual serial No. in the register.
(ii) Date of registration.
'No' (i) Date of issuing the notice (see Section 21).
(ii) Date of registration
(iii) Date of prosecution
Form 6
[See Rule 7]
Notification Form for a Still Birth
| Date of still birth | Sex of the child | Place of still birth (with full address) | Name and local address of parent |
| (1) | (2) | (3) | (4) |
Signature of the person notifying Name and Designation Date..........................
For the use of Registration Office-
(a) Whether registered or not;
(b) If-
'Yes' (i) Annual serial No. ion the register.
(ii) Date of registration.
'No' (i) Date of issuing the notice (see Section 21).
(ii) Date of registration.
(iii) Date of prosecution.
Form 7
[See Rule 7]
Notification Form for a Death
| Name and address of the deceased* | Sex | Age at death | Date of death | Place of death (with full address) |
| (1) | (2) | (3) | (4) | (5) |
Signature of the person notifying Name and Designation Date
For the use of Registration Office-
(a) Whether registered or not;
(b) If-
'Yes' (i) Annual serial No. in the register.
(ii) Date of registration.
'No' (i) Date of issuing the notice (see Section 21).
(ii) Date of registration.
(iii) Date of prosecution.
*In the case of a child without a name, the name of parent may be given.
Form 8
[See Rule 8]
Medical Certificate of Death
Name of deceased..........
Date of death........
I hereby certify that I attended deceased from to and last saw him on......
| I | *Cause of Death | Approximate interval between onset and death. |
| Disease or condition directly leading to death | ||
| (This does not mean the mode of dying e.g., heart failure, asthenia, etc. It means the disease, injury, or complication which caused death) | (a) .............. due to (or as a consequence of) | |
| Antecedent causes- | ||
| Morbid conditions, if any, giving rise to the above cause stating the underlying condition last | (b) ......... due to (or as a consequence of) (c) ................. | |
| II | ||
| Other significant conditions- | ||
| Contributing to the death, but not related to the disease or condition causing it | .......................... .......................... | |
| If deceased was a female- | ||
| Was the death associated with pregnancy............. | ||
| Was there a delivery.......... | ||
| If death was due to external causes (violence) fill in also the following : | ||
| Accident, suicide or homicide............... Date of injury..............
How did injury occur................... Signed by.............................. Designation........................M.B.B.S., R.M.P. etc. |
||
| Registration No............... | ||
| Address...........Date............ | ||
*Out of (a), (b), and (c) etc., underlying cause of death may be marked (V) by the medical practitioner.
Form 9
[See Rule 9]
Government of..........
Department of..........
Certificate of Birth
(Issued under Section 12/issued under Section 17 of the Registration of Births and Deaths Act, 1969)
This is to certify that the following information has been taken from the original record of birth which is in the register for (local area) of Tehsil of District of State.....................
| Name.............. | |
| Sex............... | |
| Date of birth......... | Registration No............ |
| Place of Birth........ | Date of Registration............ |
| Name of father/mother ............ | Permanent address of father/ mother.................. |
| Nationality of father /mother | |
| Seal | |
| Date.......... | |
| Note : |
Form 10
[See Rule 9]
Government of........
Department of...........
Certificate of Death
(Issued under Section 12/issued under Section 17 of the Registration of Births and Deaths Act, 1969).
This is to certify that he following information has been taken from the original record of birth which is in the register for (local area) of Tehsil of District of State..................
| Name.............. | Nationality............... |
| Sex............... | Permanent address.............. |
| Date of death......... | Registration No............ |
| Place of death........ | Date of Registration............ |
| Name of father/mother/husband ............ |
Signature of issuing authority Seal
Date:
*Note. - In the case of death no disclosure shall be made of particulars regarding the cause of death as entered in the Register.
[See Proviso to Section 17 (1)]
Form 11
[See Rule 13]
Register of Births and Deaths
Part I-Live Births
Taluk/Tehsil/Block/Thana, Registration Unit/Village/Town/ Municipality
Year....... District..........
| Serial No. | Date of | Sex | Name | Place of Birth* | Permanent residential address of parent | |
| Registration | Birth | |||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Father | Mother | ||||||||
| Name | Literacy | Occupation | Nationality | Religion | Name | Literacy | Occupation | Nationality | Religion |
| 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 |
| Age of mother in completed years at confinement | Order of birth (i.e. number of live births including the birth registered | Type of attention of delivery† | Informant's | Signature of left thumb mark of the informant if the information is given orally | Signature of the registrar/Sub-Registrar | Remarks | |
| Name | Address | ||||||
| 18 | 19 | 20 | 21 | 24-a | 22 | 23 | 24 |
*If the delivery took place in hospital or any other institution, write 'Hospital* or 'Institution' giving its name, otherwise, give full postal address of the place of birth,
† If the delivery was conducted in a hospital or maternity home write the name of institution; otherwise mentioned whether it was conducted by the qualified or unqualified mid-wife and give her name.
Note. - 1. In the case of illegitimate birth the word illegitimate should be entered in the remarks columns and no person's name should be entered as that of the father, unless there is a joint request of the mother and the person acknowledging himself to be father of the child.
- In the case of multiple births make separate entry for each arid a reference in the remarks column.
- If the person is a non-worker, insert the word Nil in the column for occupation.
Form 12
[See Rule 13]
Register of Births and Deaths
Year...... District.....
Part II-Still Births
Taluk/Tehsil/Block/Thana, Registration Unit/Village/Town/Municipality
| Serial No. | Date of | Sex | Place of Birth* | Permanent residential address of parent | Father | |||||
| Registration | Birth | Name | Literacy | Occupation | Nationality | Religion | ||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
| Mother | Type of attention of delivery† | Informant's | Signature of left thumb mark of the informant if the information is given orally | Signature of the registrar/Sub-Registrar | Remarks | ||||||
| Name | Literacy | Occupation | Nationality | Religion | Age of mother in completed years at confinement | Name | Address | ||||
| 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 19-a | 20 | 21 | 22 |
*If the delivery took place in a hospital or any other institution, write "Hospital" or "Institution" giving its name, otherwise, give full postal address of the place of birth,
†If the delivery was conducted in a hospital or maternity home write the name of institution; otherwise mention whether it was conducted by the qualified or unqualified mid-wife and give her name.
Note. - 1. In the case of illegitimate birth the word illegitimate should be entered in the remarks columns and no person's name should be entered as that of the father, unless there is a joint request of the mother and the person acknowledging himself to be father of the child.
- In the case of multiple births make separate entry for each and a reference in the remarks column.
- If the person is a non-worker, insert the word Nil in the column for occupation.
Form 13
[See Rule 13]
Register of Births and Deaths
Year. District.
Part II-Deaths
Taluk/Tehsil/Block/Thana/Registration Unit/Village/Town/Municipality
| Date of | Deceade's | |||||||||||
| Serial No. | Registration | Death | Name | Name of father/ husband | Place of Death | Age | Sex | Marital status | Occupation | Religion | Nationality | Permanent residential address* |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
| Cause of death | Whether medically certified or not | Kind of medical attention received if any | Informants | Signature of left thumb mark of the informant if the information is given orally | Signature of the registrar/ Sub-Registrar | Remarks | |
| Name | Address | ||||||
| 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 |
The address of the parents, in case of a child, husband/late husband in case of married women/widow and deceased, if independent are to be given in this column.
Note. - 1. If the case of death is not medically certified ascertain the cause from the list of important causes of death.
- If the deceased was over one year of age, give are in completed years. If the deceased was under one year of age, give age in completed months and if below one month, give age in completed number of days and if below one day in hours.
- If the person is a non-worker, insert the word Nil in the column for occupation.
Form 14
[See Rule 15]
Mid year population.
Weekly return of births and deaths in town for the week ending.........
| Registration Units | Latest census population | Live births | Deaths | Rates | |||||||
| Total | Covered | Total | Covered | P | M | F | P | M | F | Birth rate | Death rate |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| Death from | |||||||||
| Cholera | Small-pox | Plague | Fever | Dysentery and Diarrhoea | Respiratory diseases | Deliveries and complications of pregnancy i.e., maternal deaths | Other causes | Infant deaths | |
| 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 |
Note. - Still Births are not to be included in the live births or deaths
Form 15
[See Rule 15]
Vital statistics for the month........ year....... in Municipality/Cantonment of......
Part A
Live Births registered by sex, type of attention at delivery and still births by sex
| Registration Units | Latest census population | Live Births | ||||
| Total | Covered | Total | Covered | Person | Male | Female |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Type of attention at delivery | Still-Births | |||||
| Institutional | Physician nurse and trained mid-wife | Untrained mid-wife | Others | Person | Male | Female |
| 8 | 9 | 10 | 11 | 12 | 13 | 14 |
Form 15
[See Rule 15]
Vital statistics for the month of ...... year....... in the Municipality/Cantonment of.....
Part B
Live Births by age of mother and birth order
| Age of mother | Birth order | ||||||||||||
| 1st | 2nd | 3rd | 4th | 5th | 6th | 7th | 8th | 9th | 10th | Over 10 | Not known | Total Live Births | |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| All age below 15 15-19 20-24 25-29 30-34 35-39 40-44 45 and over Not known Total Live Births | |||||||||||||
Form 15
[See Rule 15]
Vital statistics for the month of ...... year....... in the Municipality/Cantonment of.....
Part C
Live births by sex, religion literacy and occupation of parents
| Father | |||||||
| Religion | |||||||
| Birth order | Hindus | Muslims | Christians | Sikhs | Buddhists | Jains | Others |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| M F P I Over 10 Not known | |||||||
| Father | |||||||
| Literacy | Occupation* | ||||||
| Graduate and above | Hr. Secondary, matriculation or equivalent examination | Middle School | Other literates | Illiterate | Total | Cultivators | Non-workers |
| 9 | 10 | 11 | 12 | 13 | 14 | 15-23 | 24 |
* (1) Cultivators, (2) Agricultural Labourers, (3) Professional, Technical and related workers, (4) Administrative, Executive and Managerial workers, (5) Clerical workers, (6) Sale workers (7) Service workers, (8) Farmers, Fishermen, Hunters, Loggers etc. and related workers, (9) Production and other related workers, Transport Equipment Operators and Labourers, (10) Non-workers.
Form 15
[See Rule 15]
Vital statistics for the month ...... year....... in the Municipality/Cantonment of.....
Part C
Live births by sex, religion literacy and occupation of parents
| Mother | |||||||
| Literacy | Occupation* | ||||||
| Graduate and above | Hr. Secondary, matriculation or equivalent examination | Middle School | Other literates | Illiterate | Total | Cultivators | Non-workers |
| 25 | 26 | 27 | 28 | 29 | 30 | 31-39 | 40 |
* (1) Cultivators (2) Agriculture Labourers, (3) Professional, Technical and related workers, (4) Administrative Executive and Managerial workers, (5) Clerical workers, (6) Sale workers (7) Service workers, (8) Farmers, Fishermen, Hunters Loggers etc. and related workers, (9) Production and other related workers, Transport Equipment Operators and Labourers (10) Non-workers.
Form 15
[See Rule 15]
Vital statistics for the month ...... year....... in the Municipality/Cantonment of.....
Part D
Deaths registered by type of certifies type of attention at death, religion Marital status and occupation
| Registration Units | Latest census population | Total deaths | Kind of medical attention | |||||||
| Total | Covered | Total | Covered | Total | Number medically certified | Others | Institutional | Qualified medical practitioner (allopathy) | Qualified medical practitioner (other systems) | Others |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
| M F P | ||||||||||
| Religion | Marital Status | Occupation* | ||||||||||
| Hindus | Muslims | Christians | Sikhs | Buddhists | Jains | Others | Never married | Currently married | Widowed | Separated or divorced | Cultivators | Non-Workers |
| 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23-31 | 32 |
| M F P | ||||||||||||
*(1) Cultivators, (2) Agricultural Labourers, (3) Professional, Technical and related workers, (4) Administrative, Executive and Managerial workers, (5) Clerical workers, (6) Sale workers (7) Service workers, (8) Farmers, Fishermen, Hunters, Loggers etc. and related workers, (9) Production and other related workers, transport Equipment Operators and Labourers.
Form 15
[See Rule 15]
Vital statistics for the month ...... year....... in Municipality/Cantonment.....
Part E
Causes of death by age and sex
| Age Group | ||||||||||||||
| Code | Cause of death* | Sex | Total | Below 24 hours | 1-7 days | 7 days-below 1 month | 1-3 months | 3-6 months | 6-9 months | 9 months-1 year | 1-4 years | 5-9 years | 10-14 years | 15-19 years |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
| Age Group | |||||||||||
| 20-24 years | 25-29 years | 30-34 years | 35-39 years | 40-44 years | 45-49 years | 50-54 years | 55-59 years | 60-64 years | 65-69 years | 70-74 years | 75+ years |
| 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 |
* The list of causes of death would be as prescribed by the Registrar General India.
Form 16
[See Rule 16]
Table 1(a): Census Population (to the nearest thousand) of district
| Sl. No. | District | Total population | Rural | Urban | ||
| Male | Female | Male | Female | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Population not under registration* | Population of town each with population 30,000 and over | ||||
| Rural | Urban | ||||
| Male | Female | Male | Female | Male | Female |
| 8 | 9 | 10 | 11 | 12 | 13 |
| 1 | A | 19 |
| 19 | ||
| 2 | B | 19 |
| 19 | ||
| 3 | C | 19 |
| 19 | ||
| Total |
* If the registration extends to the whole of the State/Union Territory, columns 8,9,10 and 11 need not be filled.
Form 16
Table 1 (b): Census population (To the nearest thousand) of district by religion
| Sl. No. | District | Rural | Urban | |||||||
| Hindu | Muslim | Christian | Others | Hindu | Muslim | Christian | Others | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
| 1 | A | 19 |
| 19 | ||
| 2 | B | 19 |
| 19 | ||
| 3 | C | 19 |
| 19 | ||
| Total |
Note. Population of any special religious, cultural and social group selected will also be shown separately.
Form 16
Table 1 (c): Returns not received
| Sl. No. | District | Number of Monthly returns due | Number of monthly returns not received | ||
| Rural | Urban | Rural | Urban | ||
| 1 | 2 | 3 | 4 | 5 | 6 |
| 1 A
2 B 3 C 4 D 5 E |
|||||
Form 16
Table 2 (a): Key vital statistics by district for the year......
| Serial No. | District | Mid-year estimated population | Total live birth | Total deaths | Infant deaths | Maternal deaths | Still Births | Total | |
| Males | Females | ||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| 1 A 2 B 3 C 4 D 5 E | |||||||||
Form 16
Table 2 (b) : Vital rates by district
| Serial No. | District | Live birth rates | Death rates | Infant death rates | |||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| 1 A 2 B 3 C 4 D 5 E | |||||||||||||
Form 16
Table 2 (c)-Key vital statistics of individual town with population... and over as of the last census
| Serial No. | Town | Mid-year estimated population | Total live birth | Total deaths | Infant deaths | Maternal deaths | Still Births | ||
| Males | Females | Total | |||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| 1 A 2 B 3 C 4 D 5 E | |||||||||
Form 16
Table 2 (d)-Vital rates of individual towns
| Serial No. | Town | Live birth rates* | Death rates* | Infant death rates* | |||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| 1 A 2 B 3 C 4 D 5 E | |||||||||||||
* The rates for four consecutive years (the 'current' year and three proceeding years) should be given.
Form 16
Table 3(a)-Live births by month and according to area
| Month | Live Births | ||
| Total | Rural | Urban | |
| 1 | 2 | 3 | 4 |
| January February March April May June July August September October November December Yearly Total | |||
Form 16
Table 3 (b) : Live births by the type of attention at delivery
| Rural | Urban including towns with population less than... | Towns with population.... and over | |||||||||||
| Domiciliary | Domiciliary | Domiciliary | |||||||||||
| Months | Total births | Institutional | Physician, nurse and trained mid-wife | Untrained mid-wife | Others | Institutional | Physician, nurse and trained mid-wife | Untrained mid-wife | Others | Institutional | Physician, nurse and trained mid-wife | Untrained mid-wife | Others |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| January February March April May June July August September October November December Yearly Total | |||||||||||||
Note. Some States may find it more convenient to show only yearly totals, and not month by month.
Form 16
Table 4-Live birth by sex and religion
| Hindu | Muslim | Christian | Others | |||||||||||
| Serial No. | District | Total births | Male | Female | Person | Male | Female | Person | Male | Female | Person | Male | Female | Person |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
| 1. A Rural Urban Total 2. B Rural Urban Total | ||||||||||||||
Form 16
Table 5(a)-Live births according to their birth order by religion and father's literacy group for individual towns
| Town | Last census population | Hindu | Muslim | ||||||
| Graduate and above | Hr. Secondary, matriculation or equivalent examination | Rest | Total | Graduate and above | Hr. Secondary matriculation equivalent examination | Rest | Total | ||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Christian | Others | Total birth | Birth order | |||||||||
| Graduate and above | Hr. Secondary, matriculation or equivalent examination | Rest | Total | Graduate and above | Hr. Secondary, matriculation or equivalent examination | Rest | Total | Graduate and above | Hr. Secondary, matriculation or equivalent examination | Rest | Total | |
| 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 |
| 1 2 3 4 5 6 7 8 9 Over 10 Not stated | ||||||||||||
Note Total figures for "all towns" will also be shown.
Form 16
Table 5 (b)-Live births by age of mother and order of births for individual towns
| Age of mother | Total births | Birth order | |||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | Over 10 | Not stated | ||
| Below 15 years 15-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years 50 and over years | |||||||||||||
Note Number of births, for which information is not given .... Total figures for all towns will also be shown.
Form 16
Table 6-Deaths by sex and age
| Age | Total | Rural | Urban | ||||||
| M | F | P | M | F | P | M | F | P | |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Below 1 year 1-4 year 5-14 year 15-24 year 25-44 year 45-64 year 65-74 year 75 and over year | |||||||||
Form 16
Table 7-Deaths by month
| Month | Total deaths | Rural | Urban |
| 1 | 2 | 3 | 4 |
| January February ________ ________ |
Form 16
Table 7 (a)-Deaths from cholera by month
| Month | Total deaths | Rural | Urban |
| 1 | 2 | 3 | 4 |
| January February ________ ________ |
Form 16
Table 7 (b)-Deaths from small pox by month
| Month | Total deaths | Rural | Urban |
| 1 | 2 | 3 | 4 |
| January February ________ ________ |
Form 16
Table 7 (c)-Deaths from plague by month
| Month | Total deaths | Rural | Urban |
| 1 | 2 | 3 | 4 |
| January February ________ ________ |
Form 16
Table 8-Total deaths in each district by sex and religion
| Serial No. | District | Total | Hindu | Muslim | Christian | Others | ||||||||
| M | F | P | M | F | P | M | F | P | M | F | P | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
Note. Any special religious cultural or social group will also be shown as a sub-group under 'Others'
Form 16
Table 9 (a)-Distribution of deaths in a district by
| Sl. No. | District | Total deaths | Cholera | Small pox | Plague etc. | ||||
| M | F | M | F | M | F | M | F | ||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
|
Rural Urban |
|||||||||
| Total | |||||||||
Form 16
Table 9 (b)-Distribution of deaths in the State by medically certified cause, age and sex
| Cause | Total | Below 1 year | 1-4 year | 5-14 years | |||
| M | F | M | F | M | F | ||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Rural Urban | |||||||
| 15-24 years | 25-45 years | 45-64 years | 65 and over | ||||
| M | F | M | F | M | F | M | F |
| 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 |
| Rural Urban | |||||||
Form 16
*Table 9 (c)-Deaths from specified diseases in towns each with Population.... and over as of the last census
| Sl. No. | Town | Total deaths | Specified diseases |
| 1 | 2 | 3 | 4 |
*The list of specified diseases would be enumerated by Registrar General, India.
Form 16
Table 10-Infant deaths in districts by sex and religion
| Serial No. | District | Total | Hindu | Muslim | Christian | Others | ||||||||
| M | F | P | M | F | P | M | F | P | M | F | P | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
| A B C | ||||||||||||||
Note. Any special religious cultural or social group will also be shown as a sub-group under 'Others'
Form 16
Table 11-Infant deaths in the State by sex and age
| Age | Rural | Urban | Total | |||
| M | F | M | F | M | F | |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Below 24 hours 1-7 days 7 days to below 1 month 1 month to below 3 months 3 months to below 6 months 6 months to below 12 months Total | ||||||
Form 16
Table 12 (a)-Small pox, Tetanus deaths by age
| Sector 1 | Name of disease 2 |
| Total (a) Rural (b) Urban Total (b1) Urban excluding towns with population ... and over (b2) Towns with population... and over | Small pox Tetanus Small pox Tetanus Small pox Tetanus Small pox Tetanus Small pox Tetanus |
| Below 1 year | 1-4 years | 5-9 years | 10-14 years | ||||
| M | F | M | F | M | F | M | F |
| 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Form 16
Table 12(b)
Similar data for certain specified diseases by age may be shown for urban areas or only for towns with population... and over as may be finally decided by the Registrar General, India. Instances of the type of such diseases like Tetanus, Diptheria, Who-oping Cough, Polio, Pulmonary Tuberculosis etc.