Nagaland Registration of Births and Deaths Rules, 1972

Nagaland Registration of Births and Deaths Rules, 1972

Published vide Notification Nagaland Gazette, Extraordinary No. 7, dated 24th June, 1972

Last Updated 15th February, 2020 [nag006]

1. 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.

2. 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

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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).

12. 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.

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. 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

1. Brief description of State, its boundaries and revenue districts

2. Changes in administrative areas

3. Explanation about the difference in areas

4. Changes in Registration Area-extension

5. Administrative set up of the registration machinery at various levels

6. General response of the public towards this Act.

7. Notification of births and deaths

8. Progress in the medical certification of cause of death

9. Maintenance of records

10. Search of births and deaths register for issue of certificates

11. Delayed registrations

12. Prosecutions and compounding of offences

13. Difficulties encountered in implementation of there Act-

(i) Administrative

(ii) Others

14. Orders and instructions issued under the Act

15. General remarks

Form 2

[See Rule 5]

Live Birth Report

Serial No.......

Registration Unit/Village/Town/Municipality/Taluk/Tahsil/Block/Thana................District................

1. Date of birth......

2. Sex : male/female........

3. Name of child.........

4. Place of birth.....

5. Permanent residential address..........

6. Father's-

(i) Name..........

(ii) Literacy.....

(iii) Occupation.........

(iv) Nationality

(v) Whether SC/ST*

(vi) Religion

7. Mother's-

(i) Name.....

(ii) Literacy.....

(iii) Occupation.........

(iv) Nationality (vi) Religion

(v) Whether SC/ST*

8. Age of mother in completed years at confinement

9. Order of birth (Number of live births including the births registered)

10. Type of attention at delivery

11. 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

1. Date of birth......

2. Sex : male/female .....

3. Place of birth.....

4. Permanent residential address of parent........

5. Father's-

(i) Name.........

(ii) Literacy....

(iii) Occupation......

(iv) Nationality

(v) Whether SC/ST*

(vi) Religion

6. Mother's-

(i) Name.....

(ii) Literacy....

(iii) Occupation......

(iv) Nationality

(v) Whether SC/ST*

(vi) Religion

7. Age of mother in completed years at confinement

8. Type of attention at delivery

9. 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.

1. Date of death

2. Full name of the deceased

3. Name of the father/husband

4. Place of death

5. Age

6. Sex : male/female

7. Marital status

8 Occupation

9. Religion

10. Nationality

11. Permanent residential address

12. *Cause of death

13. Whether medically certified (Yes/No)

14. Kind of medical attention received, if any

15. Whether SC/ST†

16. 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 ............

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
Serial No.	Registration	Birth	Sex	Name	Place of Birth*	Permanent residential address of parent
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
Age of mother in completed years at confinement		Type of attention of delivery†	Name	Address		Signature of the registrar/Sub-Registrar	Remarks
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.

2. In the case of multiple births make separate entry for each arid a reference in the remarks column.

3. 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
Serial No.	Registration	Birth	Sex	Place of Birth*	Permanent residential address of parent	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	Type of attention of delivery†	Name	Address		Signature of the registrar/Sub-Registrar	Remarks
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.

2. In the case of multiple births make separate entry for each and a reference in the remarks column.

3. 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
Cause of death	Whether medically certified or not	Kind of medical attention received if any	Name	Address		Signature of the registrar/ Sub-Registrar	Remarks
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.

2. 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.

3. 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
Age of mother	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
Sl. No.	District	Total population	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		Population of town each with population 30,000 and over
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
Sl. No.	District	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
Month	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
Town	Last census population	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	Birth order
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
Age of mother	Total births	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
Age	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
Serial No.	District	Total	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
Cause	Total	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

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
Age	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.