MEDICAL CETIFICATE OF BIRTH
Certificate No.: ************
Neonatal Name: ** **** Gender: Female Time of Birth: 6:41am 26th July 2016
Gestational Age: 40+2 Weeks Birth Weight: **g Birth Length: **cm
Birth Place: ****District, Chengdu City, Sichuan Province, P. R. China
Medical Institution: Angel Women’s & Children’s Hospital (Shuhan Hospital)
Mother’s Name: ** **** Age: ** Nationality: Australia Ethnic Group: /
Address: ****Street, ****District, Chengdu City, Sichuan Province, P. R. China
Valid Identification: Identity Card □ Passport□√ Others □
Valid Identification No.: XXXXXXXX
Father’s Nate: ** **** Age: ** Nationality: Australia Ethnic Group: /
Address: ****Street, ****District, Chengdu City, Sichuan Province, P. R. China
Valid Identification: Identity Card □ Passport□√ Others □
Valid Identification No.: XXXXXXXX
Issued Authority (Stamp): Angel Women’s & Children’s Hospital (Shuhan Hospital)
Date Issued: 8th August 2016
