CERTIFICATE OF LIVE BIRTH - Municipal Form No. 102 - Fill Out Completely

Sep 17, 2026

Uploaded by Paura

Certificate of Live Birth (Municipal Form No. 102, revised January 1993) is an official civil registry form from the Office of the Civil Registrar General of the Republic of the Philippines. It collects complete and legible details for the child, including name, sex, date of birth, and place of birth, plus birth type, order, and weight. The form also records parents’ information, citizenship, religion, occupations, ages, marriage details, attendant certification, informant data, and office processing fields for civil registrar use.

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Certificate of Live Birth (Municipal Form No. 102)

Child Information

Parents Information

Attendant Certification and Informant Data

Office Use and Remarks

| Municipal Form No. 102 (To be accomplished in quadruplicate)(Revised January 1993)
Republic of the Philippines
OFFICE OF THE CIVIL REGISTRAR GENERAL
CERTIFICATE OF LIVE BIRTH
(Fill out completely, accurately and legibly. Use ink or typewriter.
Place X before the appropriate ANSWER IN ITEMS 2, 5A, 5B AND 19A.) | | | | | | | | REMARKS/ANNOTATION | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Province City/Municipality | | | | | | Registry No. | | | | | C
H
I
L
D | 1. NAME (First) (Middle) (Last) | | | | | | | FOR OCRG USE ONLY: Population reference No.
| | | | 2. SEX
1 Male 2 Female | | 3. DATE OF BIRTH (day) (month) (year) | | | | | | | | | | | | | | | | TO BE FILLED UP AT THE OFFICE OF THE CIVIL REGISTRAR
41

48

49 50

56
| | | | 4. PLACE OF (Name of Hospital/Clinic/Institution/ (City/Municipality) (Province) BIRTH House No. , Street, Barangay) | | | | | | | | | | | 5a. TYPE OF BIRTH
1 Single 2 Twin 3 Triplet. Etc. | | b. IF MULTIPLE BIRTH, CHILD WAS
1 First 2 Second
3 Others, Specify | | | | | | | | | c. BIRTH ORDER (live births and fetal deaths
including this delivery)
(first, second, third, etc. ) | | | d. WEIGHT AT BIRTH
grams | | | | | | | M
O
T
H
E
R | 6. MAIDEN (First) (Middle) (Last) NAME | | | | | | | | | | | 7. CITIZENSHIP | | | 8. RELIGION | | | | | | | | 9a. Total number of children born alive: | b. No. of Children still living including this birth: | | | | c. No. of children born alive but
are now dead: | | | | | | | | | | | | | 61

62

68

70

76 | 64

69

72 74

79 | | | 10. OCCUPATION | | | | | 11. Age at the time of this birth:
_______years | | | | | | 12. RESIDENCE (House No. , Street, Barangay) (City/Municipality) (Province) | | | | | | | | | | F
A
T
H
E
R | 13. NAME (First) (Middle) (Last) | | | | | | | | | | | 14. CITIZENSHIP | | | | 15. RELIGION | | | | | | | 16. OCCUPATION | | | | | | 17. Age at the time of this birth:
_______years | | | | 18. DATE AND PLACE OF MARRIAGE OF PARENTS (If not married, accomplish Affidavit of Acknowledgement/Admission of Paternity at the back. )
19a. ATTENDANT 1 Physician
4 Hilot (traditional Midwife) 2 Nurse
5 Others (Specify) 3 Midwife 19b. CERTIFICATION OF BIRTH
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.
Signature Name in Print Title or Position
Address
Date | | | | | | | | | | | | | | | | | | |
81

86 87

88 91

93

94
| | | 20. INFORMANT
Signature Name in Print
Relationship to the child
Address
Date
21. PREPARED BY 22. RECEIVED AT THE OFFICE OF
THE CIVIL REGISTRAR Signature Signature Name in Print Name in Print Title or Position Title or Position Date Date | | | | | | | | | |

FAQs

What information must be provided for the child on the certificate of live birth?

The form requires the child’s full name, sex, date of birth (day/month/year), and place of birth (hospital/clinic/institution, city/municipality, province), along with birth type, birth order, and weight at birth.

How does the form handle multiple births and birth order?

It includes a section for the type of birth (single, twin, triplet, etc.) and, if multiple, indicates whether the child is first, second, or others. It also asks for birth order including live births and fetal deaths, stating first/second/third, and so on.

Who completes the certification and what does it confirm?

The attendant completes the certification of birth, stating attendance at the birth of the child born alive, including the time (o’clock am/pm) and the date, with signature, printed name, title or position, address, and date.

Sep 17, 2026

Uploaded by Paura