Hospital Birth Certificate Request Letter Format

Sample Template Example of Application / Complaint Letter to municipality / Hospital for Change / Correction in Birth Certificate in India in word / .doc


The Superintendent,
12/4 M G Road, Apollo Medical College & Hospital,
New Delhi -  112 212

Dear Sir,

Reg : Mistake in Discharge certificate dt.24.02.2014 – Patient Smt. Anika Saha

Ref : Patient Registration No. TG12067701

I am to inform you that the  Patient Smt. Anika Saha, my wife , while discharged with newly born  baby , on 24.02.2014 two discharge certificates were issued by you – one for  Patient Smt. Anika Saha and other for the newly born baby.

While I approached New Delhi municipal corporation for registration of birth of our baby and issue Birth Certificate , they informed that there is anomalies in the addresses  and in both the certificates the addresses will be same .

I have verified both the certificates and found that in the discharge certificate of  Patient Smt. Anika Saha the address is mis- spelled  , and hence I request you to make necessary corrections as per correct residential address as hereunder ( Proof of address  is  enclosed for verification ), to enable me to approach New Delhi Municipality for acceptance of your discharge certificates for issue of Birth Certificate  for my newly born baby , born in your Hospital on 14.02.2014

Municipality/Village            : ---------------
Post Office                            :  ----------------
District                                  :  ----------------
State                                      : -----------------

I hope  my request will receive your due favour for compliance at the earliest.

Thanking you,
Yours faithfully,

( Ajay Saha,
W/o Smt. Anika Saha &
F/o Newly born baby as above. )

Download Hospital Birth Certificate Format


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