0
edits
No edit summary |
No edit summary |
||
Line 90: | Line 90: | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Name of Child''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Name of Child''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Sex''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Sex''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Race''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Race''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Parents' Names''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Parents' Names''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Midwife/Doctor''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Midwife/Doctor''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Date & Place of Birth''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Date & Place of Birth''' | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|- | |- | ||
| valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Residence''' | | valign="middle" align="center" width="52%" bgcolor="#99ccff" height="25" | '''Residence''' | ||
| valign="middle" align="center" width="16%" height="25" | <br> | | valign="middle" align="center" width="16%" height="25" | <br> | ||
| valign="middle" align="center" width="16%" height="25" | | | valign="middle" align="center" width="16%" height="25" | | ||
|} | |} | ||
edits