出生证明模板

出生医学证明

新生儿姓名男女

出生日期年月日时分

出生地省市县（区）乡

出生孕(周)周

健康状况良好一般差

体重克身长公分

母亲姓名年龄国籍民族

身份证号

父亲姓名

身份证号

出生地点分类医院妇幼保健院家庭其他

接生机构名称

出生编号签发日期年月日

签发机构(盖专用章)

BIRTH CERTIFICATE

Full name of baby male female

Date of birth year month day hour minute

Place of birth Province City Country (District) Township Gestation (week)week

Health status well normal week

Weight g Height cm

Full name of mother Age Nationality Nationality Identity card NO.

Full name of father

Identity card NO.

Type of place General hospital MCH hospital Home other Name of facility

Birth No Date of Issue Year Month Day

Issuing organization (seal)