Surat Keterangan Kelahiran

Layanan Surat Keterangan

Surat Keterangan Kelahiran
Formulir pengajuan surat keterangan kelahiran untuk warga desa Molompar Atas.
Isi Formulir

Formulir Surat Keterangan Kelahiran

Bayi / Anak

Nama Jenis Kelamin Tempat Dilahirkan Tanggal Lahir Pukul Jenis Kelahiran Anak Ke Penolong Kelahiran Berat Bayi (kg)

Ibu

NIK Nama Lengkap Tanggal Lahir / Umur Pekerjaan Alamat Kewarganegaraan Tanggal Perkawinan

Ayah

NIK Nama Lengkap Tanggal Lahir / Umur Pekerjaan Alamat Kewarganegaraan

Pelapor

NIK Nama Lengkap Tanggal Lahir / Umur Pekerjaan Alamat Kewarganegaraan

Catatan: Formulir ini diisi secara online agar warga tidak perlu antri atau membawa dokumen di tahap awal.

Namun, untuk mendapatkan Surat Keterangan Kelahiran yang asli (ditandatangani dan diberi cap resmi), pemohon tetap harus datang ke balai desa.

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