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)
