Now, after having reviewed some more facts, I am going to jump on the "likely fake" bandwagon.
Please see the thread, "Kenya Register of Birth," for my rationale for doing so.
Not to say that I am absolutely, 100%, saying it's a fake, but it looks more suspicious to me.
What you posted is a fairly recent blank form. How can that possibly have ANY relevance, one way or another, for a 1961/1964 document?