111.93.47.72
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Submitted URL: http://111.93.47.72/csbndmc/rbd/onlinebrithcertificates.php
Effective URL: https://111.93.47.72/csbndmc/rbd/onlinebrithcertificates.php
Submission Tags: falconsandbox
Submission: On May 07 via api from US — Scanned from DE
Effective URL: https://111.93.47.72/csbndmc/rbd/onlinebrithcertificates.php
Submission Tags: falconsandbox
Submission: On May 07 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: doctorreport_F — POST onlinebrithcertificates.php
<form name="doctorreport_F" method="post" action="onlinebrithcertificates.php" onsubmit="javascript:return termchk();">
<table width="99%" align="left">
<tbody>
<tr>
<td colspan="4"> </td>
</tr>
<!--<tr>
<td class="barheading" align="left" colspan="4">Search For Birth Certificate</td>
</tr>-->
<tr>
<td colspan="4" class="redtext" align="center"><strong></strong></td>
</tr>
<tr>
<td align="center" colspan="4"> </td>
</tr>
<tr>
<td width="14%" align="left"> </td>
<td width="18%" align="left" class="bodytext"><strong>Search</strong><span class="redtext"><strong>*</strong></span></td>
<td width="68%" align="left" class="bodytext"><input name="searchoption_f" id="searchoption_f" type="radio" value="1" onclick="javascript: selelctsearchoption(1);"><span class="bodytext">Search by registration number</span> <input
name="searchoption_f" id="searchoption_f" type="radio" value="2" onclick="javascript: selelctsearchoption(2);"><span class="bodytext">Search without registration number</span></td>
</tr>
<tr>
<td align="left" colspan="3">
<div id="radio_1" style="display: none;">
<table border="0" cellpadding="1" cellspacing="3" width="100%">
<tbody>
<tr>
<td align="left" width="14%"> </td>
<td width="18%" align="left" class="bodytext"><strong>Child Reg.Id</strong></td>
<td width="68%" align="left">
<input type="text" name="format" value="MCDOLIR" size="10" readonly="" class="input">
<input type="text" name="regyear" class="input" size="6" maxlength="4">
<input type="text" name="bregNo" class="input" size="13" maxlength="9"> <span class="redtext">(ex: MCDOLIR - 0110 - 123456)</span>
</td>
</tr>
<tr>
<td align="left" valign="top"> </td>
<td align="left" valign="top"> </td>
<td align="left" valign="top" class="redtext"><strong><span class="redtext">(OR)</span></strong></td>
</tr>
<tr>
<td align="left" valign="top"> </td>
<td align="left" valign="top" class="bodytext"><strong>Old Registration Number</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left" valign="top">
<input type="text" name="brefNo" class="input" maxlength="25" size="22"> <span class="redtext">(For Events Registered Before 4th June 2010)</span>
</td>
</tr>
<tr>
<td align="left"> </td>
<td align="left" class="bodytext"><strong>Date of Birth</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cDob1" id="cDob1" size="22" class="input" readonly="">
<input type="button" name="date1" value="Date" class="input" onclick="displayCalendar(document.forms[0].cDob1,'dd/mm/yyyy',this)" ;="">
</td>
</tr>
<tr>
<td align="left"> </td>
<td align="left" class="bodytext"><strong>Gender</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input name="sex1_f" id="sex1_f" type="radio" value="M">
<span class="bodytext">Male</span> <input name="sex1_f" id="sex1_f" type="radio" value="F">
<span class="bodytext">Female</span>
<input name="sex1_f" id="sex1_f" type="radio" value="O">
<span class="bodytext">Other</span>
</td>
</tr>
<tr>
<td align="left"> </td>
<td align="left" class="bodytext"><strong>Mother Name</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cMname1" id="cMname1" size="22" class="input" maxlength="50">
<span class="redtext">Minimum of 3 Characters</span>
</td>
</tr>
<tr>
<td align="left"> </td>
<td align="left" class="bodytext"><strong>Father Name</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cFname1" id="cFname1" size="22" class="input" maxlength="50">
<span class="redtext">Minimum of 3 Characters</span>
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td align="left" colspan="3">
<div id="radio_2" style="display: none;">
<table border="0" cellpadding="1" cellspacing="3" width="100%">
<tbody>
<tr>
<td align="left" colspan="2"> </td>
<td width="18%" align="left"> </td>
<td width="68%" align="left" class="bodytext" style="color:#0066FF"><strong>If record is incorrect please use following search creteria for searching BIRTH record.</strong></td>
</tr>
<tr>
<td align="left" colspan="2"> </td>
<td align="left" class="bodytext"><strong>Date of Birth</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cDob" id="cDob" size="22" class="input" readonly="">
<input type="button" name="date" value="Date" class="input" onclick="displayCalendar(document.forms[0].cDob,'dd/mm/yyyy',this)" ;="">
</td>
</tr>
<!--<tr>
<td align="left" colspan="2"> </td>
<td align="left" class="bodytext"><strong>Child Name</strong></td>
<td align="left"><input type="text" name="cName" id="cName" size="22" class="input" maxlength="50">
<span class="redtext">Minimum of 3 Characters</span></td>
</tr>-->
<tr>
<td align="left" colspan="2"> </td>
<td align="left" class="bodytext"><strong>Gender</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input name="sex_f" id="sex_f" type="radio" value="M">
<span class="bodytext">Male</span> <input name="sex_f" id="sex_f" type="radio" value="F">
<span class="bodytext">Female</span>
<input name="sex_f" id="sex_f" type="radio" value="O">
<span class="bodytext">Other</span>
</td>
</tr>
<tr>
<td align="left" colspan="2"> </td>
<td align="left" class="bodytext"><strong>Mother Name</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cMname" id="cMname" size="22" class="input" maxlength="50">
<span class="redtext">Minimum of 3 Characters</span>
</td>
</tr>
<tr>
<td align="left" colspan="2"> </td>
<td align="left" class="bodytext"><strong>Father Name</strong><span class="redtext"><strong>*</strong></span></td>
<td align="left"><input type="text" name="cFname" id="cFname" size="22" class="input" maxlength="50">
<span class="redtext">Minimum of 3 Characters</span>
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td align="center" colspan="4"> </td>
</tr>
<tr>
<td align="left" width="14%"> </td>
<td align="left" colspan="3" class="redtext"><input name="trmchk" id="trmchk" value="1" type="checkbox"> It is certified that I am duly qualified to obtain this birth certificate as per relevant Act/ Rule being nearest relative, I am
liable for consequences, In case of any inconformity found in this regard at any stage.</td>
</tr>
<tr>
<td align="center" colspan="4"> </td>
</tr>
<tr>
<td align="left" width="14%"> </td>
<td align="left" colspan="3" class="bodytext"> <span class="redtext"><strong>Note: A sum of Rupees 21 (Certificate Charges 20-00 + Convinience Charges @ 1.8% + service tax @2.0642) wii be charged for Birth Certificate.</strong></span>
</td>
</tr>
<tr>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="4" align="center"><input type="submit" name="submit" value="Submit" class="button"> <input type="button" name="cancel" value="Cancel" class="button" onclick="javascript:history.back();"></td>
</tr>
</tbody>
</table>
</form>Text Content
Back Recommended To Use IE7.0 or Above / Mozilla Firefox. Browser Must Have JavaScript Enabled To Use This Site NDMC Home BIRTH CERTIFICATE SEARCH PROCESS Search* Search by registration number Search without registration number Child Reg.Id (ex: MCDOLIR - 0110 - 123456) (OR) Old Registration Number* (For Events Registered Before 4th June 2010) Date of Birth* Gender* Male Female Other Mother Name* Minimum of 3 Characters Father Name* Minimum of 3 Characters If record is incorrect please use following search creteria for searching BIRTH record. Date of Birth* Gender* Male Female Other Mother Name* Minimum of 3 Characters Father Name* Minimum of 3 Characters It is certified that I am duly qualified to obtain this birth certificate as per relevant Act/ Rule being nearest relative, I am liable for consequences, In case of any inconformity found in this regard at any stage. Note: A sum of Rupees 21 (Certificate Charges 20-00 + Convinience Charges @ 1.8% + service tax @2.0642) wii be charged for Birth Certificate.