Birth Notification sample ENG.xlsx

	A	E	F	O
1	BELOW SAMPLE CAN BE ADAPTED ACCORDING TO THE OPERATIONAL CONTEXT
2	BIRTH NOTIFICATION
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6	The International Rescue Committee certifies by this document that
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8	NAME
9	SEX
10	DATE and TIME OF BIRTH
11	SON /DAUGHTER OF	AND
12	RATION CARD #
13	ProGres #
14	Was born in our Facilities
15	Was born in the community under the supervision of a TBA
16	Was born unattended in the community
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19			Reproductive Health Program Manager
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23	Yida Refugee Camp, South Sudan, the _________ of ____________ of 20____
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26	BIRTH NOTIFICATION
27				\
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30	The International Rescue Committee certifies by this document that
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32	NAME
33	SEX
34	DATE and TIME OF BIRTH
35	SON/DAUGHTER OF	AND
36	RATION CARD #
37	ProGres #
38	Was born in our Facilities
39	Was born in the community under the supervision of a TBA
40	Was born unattended in the community
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42
43			Reproductive Health Program Manager
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45
46
47	Yida Refugee Camp, South Sudan, the _________ of ____________ of 20____
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