Regional Institute of Medical Sciences, Imphal - Online Application for Birth Certificate

Personal Details

* Name of Child:

* Gender:

* Date of Birth:

* Father's Name:

* Mother's Name:

* Father's Aadhaar No.:

* Mother's Aadhaar No.:

* Father's Mobile No.:

Mother's Mobile No.:

Father's Email:

Mother's Email:

* Present Address:

* Permanent Address:

Uploads

* Discharge Slip issued by RIMS Hospital: (Max file size: 400kb)

Old Non-Digital Birth Certificate (if issued earlier): (Max file size: 400kb)

* Father's Aadhaar Card: (Max file size: 400kb)

* Mother's Aadhaar Card: (Max file size: 400kb)

Declaration

I declare that all the above given information is true to the best of my knowledge.

(please tick)

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