I’m wondering now if what I have is a short-form certificate. I had to get mine from PA. It’s only a half page, has date and place of birth, name of parents and their address. What else would be in a long-form certificate vs. the short form?
A few years ago, I thought I had lost the original (I had just misplaced it), so I sent for a replacement, and the replacement was a notarized photocopy of the original.
Name of doctor, time of birth, parents occupations, whether this is a first or second, etc birth. How many luve births have thiere been, how many stillborn, name of hospital.
Mine has:
At the top, the title. All it is is called “Certificate of Birth”
On the left side of the heading, there is a field for Dist. No.
On the right side of the heading, there is a registration number.
Item (1) is place of birth. County and City are filled in.
Item (2) is Titled “Usual Residence of mother” and is filled in.
Item (3) is “Childs Name” and is filled in with my full lawfull name (not in all caps, in proper English form with first letters capitalized and the rest lower case)
Item (4) is sex of child (for FReepers who don’t know, I’m a dude)
Item (5) is status of birth, ie single, twin, whatever
Item (6) is date.
Item (7) full lawfull name of my father
Item (8) is race/color of my father
Item (9) age of my father
Item (10) is birthplace of my father
Item (11) is occupation of my father
Item (12) is full maiden name of my mother
Item (13) is color or race of my mother
Item (14) is age of my mother
Item (15) is birthplace of my mother
Item (16) is children previously born of this mother (0, I am a firstborn)
Item (17) is length of pregnancy
Item (18) is my weight at birth
Item (19) is a fill in, was the blood of this childs mother tested for syphilis, and a date of when the test was done
Item (20) is what prevention for Opthalmia (eye infection caused by passing through the birth canal) and is filled in with AgNO3
Item (21) is mothers mailing address for registration purposes
The last part is a jurat section of sorts. It starts with:
“I hereby certify that I attended the birth of this child who was born alive on the date listed above”
Item (22) is the signature of attendent
Item (23) is a checkbox for Doctor or Midwife
Item (24) is the doctors address and the date signed by the doctor
Item (25) is the date filed by registrar
Item (26) is the signature of the registrar
Item (27) is a field called “Given Name Added”, it’s blank, not sure what it means
All of this is printed on a very fragile photocopy type paper, an image off of a roll of microfilm. On the left part of it, there is an indicator what roll of microfilm, and the signature of a person who works (worked?) for NYS dept of Vital statistics
It’s pretty old and blurry, but all the relevant info is there.