STAT

Municipal Form Mo. 102

Haised January 1933)

THORIT

Province CEBU

City/Municipality,

1. NAME

(To be accomplished in quadruplicate)

Republic of the Philippines

OFFICE OF THE CIVIL REGISTRAR GENERAL

CERTIFICATE OF LIVE BIRTH

(FM sut completely, accurately and legibly. Use ink or typewriter.

Plane X before the appropriate answer in Items 2, 50, 50 and 19a)

NAGA

(first)

MARC

Registry No.

2008-1863

(Last)

(Middle)

SAYON

LABA.IO

2. SEX

3. DATE OF BIRTH

(day) (manth) (year)

1 Male

4. PLACE OF
BIRTH

_ 2 Famala

(Name of Hospital/Clinic/Institution/

House No., Street, Barangay)

23

JULY 2008

(City/Municipality)

(Province)

ALPACO

CEBU

5a. TYPE OF BIRTH

1 Slogla

2 Twin

3 Triphat enc

NAGA

1 First

b. IF MULTIPLE BIRTH, CHILD WAS

2 Second

3 Others, Specify.

BIRTH ORDER (live births and fetal deaths

including this delivery)

Bissegond, third, etc.)

THE ND

d. WEIGHT AT BIRTH

6. MAIDEN

(Яht)

NAME

MARIA 18ABEL
(Middle)

GERALDEZ

2500

grams

(Last)

SAYON

7. CITIZENSHIP

MOTHER

8. RELIGION

ROMAN CATHOLIC

9a Townumber of

b. No of chikinen stili

No. of children

phildren po

alive;

10. OCCUPATION

12. RESIDENCE (House No., Street, Barangay)

thing including

this : 3

born alive but

We now dead: a

11.

Age at the time

of this birth:

HOUSEKEEPER

(City/Municipality)
26 years

(Province)

ALPICO

13. NAME

(First)

FRANCISCO

NAGA

(Middle)

BAROMAN

CEBIL

(Last)

LABAJO

(Copy for OCRG)

REMARKS/ANNOTATION

For QCRO USE ONLY:

Population Roterande No.

AT THE

2446