Location & Language

State, district, hospital name and local language

Step 1 of 4

State *

District *

Tahsil / Block *

Hospital Name *

Select Local Language *

Upload Logos & Signature

Max 200KB each — PNG or JPEG only

Step 2 of 4

Signature *

Click to upload Signature PNG / JPEG · Max 200KB

State Logo *

Click to upload State Logo PNG / JPEG · Max 200KB

Form Logo *

Click to upload Form Logo PNG only · Max 200KB

Government & Hospital Details

Auto-filled fields — edit if needed

Step 3 of 4

Government Name (English)

सरकार का नाम (Local)

Department Name (English)

विभाग का नाम (Local)

Hospital Name (English)

अस्पताल का नाम (Local)

Registrar

Registrar (Local)

Certificate Text & Local Language Fields

Certificate content lines and local language labels

Step 4 of 4

Birth Certificate Title (Local) — जन्म प्रमाण पत्र

Line No. 1 (English)

लाइन नंबर 1 (Local)

Line No. 2 (English)

लाइन नंबर 2 (Local)

Advanced Local Language Labels

Personal Info Labels

Name (Local)

Gender (Local)

Date of Birth (Local)

Place of Birth (Local)

Mother Name (Local)

Father Name (Local)

Address Labels

Birth Address (Local)

Permanent Address (Local)

Registration Labels

Reg. Number (Local)

Reg. Date (Local)

Remarks (Local)

Date of Issue (Local)

Issuing Authority (Local)

Aadhar Number (Local)

Last Line (Local)

Select language first to auto-translate all fields