Professional Documents
Culture Documents
birthcertificate-FATIMA
birthcertificate-FATIMA
birthcertificate-FATIMA
Province _________________________________________
TAWI-TAWI Registry No.
City/Municipality ___________________________________
BONGAO
62 64
12. RESIDENCE (House No., Street, Barangay) (City/Municipality) (Province)
TUBIG MAMPALLAM, BONGAO, TAWI-TAWI
13. NAME (First) (Middle) (Last)
68 69
F JAAPAR HAMIDOL HASSAN
A 14. CITIZENSHIP 15. RELIGION
T
H FILIPINO ISLAM
70 72 74
E
R 16. OCCUPATION 17. Age at the time
of this birth:
PRIVATE EMPLOYEE 36
_______years
76 79
18. DATE AND PLACE OF MARRIAGE OF PARENTS (If not married, accomplish Affidavit of
Acknowledgement/Admission of Paternity at the back.)
AUGUST 12, 2004 BONGAO, TAWI-TAWI
_______________________________________________________________________________________________
19a. ATTENDANT
_____1 Physician ______ 2 Nurse X 3 Midwife
______ 81
_____4 Hilot (traditional Midwife) ______ 5 Others (Specify)
_______________________________________________________________________________________________
19b. CERTIFICATION OF BIRTH
4:07am
I hereby certify that I attended the birth of the child who was born alive at ______________o’clock
am/pm on the date stated above.
86 87
Signature ______________________________
BONGAO, TAWI-TAWI
Address ______________________________
SALMA M. KAYTING
Name in Print ___________________________ _____________________________________
20. INFORMANT
FATHER
Relationship to the child ___________________ JULY 14, 2022
Date ________________________________
_______________________________________________________________________________________________
21. PREPARED BY 22. RECEIVED AT THE OFFICE OF
THE CIVIL REGISTRAR
94
Signature ______________________________ Signature _____________________________