Beruflich Dokumente
Kultur Dokumente
REPUBLIC OF KENYA
____________
DEPARTMENT OF THE REGISTRAR-GENERAL
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1.
NAME............................
First name
2.
DATE OF BIRTH3.SEX:
Day
Month
Male/Female*
Year
3.
PLACE OF BIRTH../..........
Kijiji and sub-location or street and town
District
4.
NAME OF FATHER............
First name
5.
First name
6.
B. APPLICANT
1.
NAME...
First name
2.
ADDRESS............
3.
Signature.
C. CERTIFICATE
Signed by R.A.
.
Countersigned by S.R.A.
Fee of KShpaid.
Date
*Delete inapplicable.
* *If certificate from Assistant Chief is not obtainable, a baptismal certificate or clinical card or doctors/midwifes certificate should be produced.
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GPK (SP) 7393100m07/2008