BIRTHS AND DEATHS REGISTRATION ORDINANCE

Hong Kong Ordinances

[Index] [Table] [Search] [Notes] [Noteup] [Previous] [Next] [Download (Current & Past)] [Download (Current only)] [繁體中文] [Help]

BIRTHS AND DEATHS REGISTRATION ORDINANCE - SCHEDULE 2



(Past version on 27/08/2007).
(Past version on 11/06/1999).
(Past version on 18/09/1998).
(Past version on 04/05/1998).
(Past version on 01/07/1997).
(Past version on 30/06/1997).



[section 29]



FORM 1 [section 4(1) & (2)]



Register form of births

出生登記表格


, 	, Births in the district of 	, Hong Kong.
	年	月	日，香港                                 區出生登記。





Registration No.

登記編號 

When and where born

出生日期及地點 

Name, if any

名字(如有的話) 

Sex

性別 

Surname and name of father

父親姓名 

Maiden surname and name

of mother

母親婚前姓氏及名字 

Signature, description and

residence of informant

申報人簽署、身分及住址 

When registered

登記日期 

Signature of registrar

登記官員簽署 

Name, if added after

registration of birth

名字

(如在出生登記後加上) 

Status of permanent resident of the Hong Kong Special Administrative Region under the Immigration

Ordinance (Cap 115)

(Established/Not established)

《入境條例》(第115章)

下的香港特別行政區永久性

居民身分

(確定/未確定) 

(Replaced L.N. 497 of 1995. Amended 80 of 1997 ss. 68 and 103; L.N. 359 of 1997; 71 of 1999 s. 3; 8 of 2006 s. 18)
_______________





FORM 2 [section 4(1) & (2)]

Register form of deaths 

死亡登記表格


, 	, Deaths in the district of 	, Hong Kong.
	年	月	日，香港                                 區死亡登記。





Registration No.

登記編號 

When and where died

死亡日期及地點 

Surname and name

姓名 

Sex

性別 

Age

年齡 

Rank, profession, or occupation 

and nationality so far as is 

known

所知的職位或職業及國籍 

Cause of death 

死因 

Signature, description and

residence of informant

申報人簽署、身分及住址 

When registered 

登記日期 

Signature of registrar

登記官員簽署 

(Replaced L.N. 497 of 1995. Amended 80 of 1997 s. 68; 8 of 2006 s. 18)

______________





FORM 3 [section 9(4)] 

Certificate of Registration of Birth

出生登記證明書





Registration No.

登記編號 

Surname and name of child

出生者姓名 

Sex

性別 

Date of birth

出生日期 

Date registered

登記日期 

Maiden surname and 

name of mother

母親婚前姓氏及名字 

Address at birth

出生時地址 

Signature of registrar

登記官員簽署 

This certificate must be produced on demand by a police officer to prove that the name of the person entered has been registered.

如遇警務人員索閱時，必須將此證明書出示，以證明上述人名已經登記。



NO FEE IS PAYABLE FOR THIS CERTIFICATE.

領取此證明書無須繳費。


(Replaced L.N. 497 of 1995)


_______________





FORM 4 [section 13(1)]

Declaration for altering or adding to the name of a child


I, (Name) ............................................................................................................................. 

(Address) ............................................................................................................................ 

(Description) ........................................................................................................................ 

Parent (or guardian) of the child of ........................................................................................ 

and .................................................................................................................... whose birth 

was registered on the ................... day of ............................................................................., 

under the name(s) of ............................................................................................... solemnly 

and sincerely declare that I desire 





(Strike out 

either (a) 

or (b) as 

required.) (a)	to add the name(s) of .................................................................... to the above-mentioned name(s). 

(b)	to alter the above-mentioned name(s) to .......................................... .....................................................................................................

And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Ordinance (Cap 11). 

(Signed) A.B.


Parent (or Guardian).


Declared at ..................................................................................................... in Hong Kong this .............................. day of ........................................................... 

Before me, 
(Signed) 


registrar.

(Replaced L.N. 214 of 1974. Amended L.N. 497 of 1994; L.N. 497 of 1995; 8 of 2006 s. 18)


_______________





FORM 5 [section 13(1)]

Declaration of name of child


I, (Name) ............................................................................................................................. 

(Address) ............................................................................................................................ 

(Description) ........................................................................................................................ 

Parent (or guardian) of the child of ......................................................................................... and ................................................................................................................... whose birth 

was registered on the .............. day of................................................................................... 

without a name, solemnly and sincerely declare that the said child has received the name(s) of ............................................................................................................................................ 

and that I desire that the said name(s) shall be added to the register. 



And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Ordinance (Cap 11). 

(Signed) A.B. 


Parent (or Guardian).


Declared at ..................................................................................................... in Hong Kong this .......................... day of ....................................................Before me,
(Signed)


registrar.
(Replaced L.N. 214 of 1974. Amended L.N. 497 of 1994; L.N. 497 of 1995; 8 of 2006 s. 18)


_______________





FORM 6 [section 13(2)]

Certificate of registration of alteration of name of child


I, A.B., Registrar [or deputy or district registrar] of Births and Deaths, do hereby certify that the name [or names] of 	 by 

which a child of one C.D. and E.F. was registered on the	day 

of 	 ,  	 , has [or have] been altered to                    and that such alteration has been entered in the register. 

Dated the 	 day of 	 ,	.
(Signed.)	A.B., a registrar of births and deaths.


Fee $110.(Amended 9 of 1957 s. 3; 1 of 1965 s. 12; 48 of 1975 s. 7; 67 of 1984 s. 10; 51 of 1986 s. 7; L.N. 497 of 1995; 80 of 1997 s. 68; 8 of 2006 s. 18)


_______________





FORM 7 [section 13(2)]

Certificate of registration of name of child 


I, A.B., Registrar [or deputy or district registrar] of Births and Deaths, do hereby certify that the name [or names] of 	 has

[or have] been given to the child of one C.D. and E.F. whose birth was registered on 

the 	day of 	 ,  	 and that such name or names has [or have] been entered in the register. 

Dated the 	 day of 	 ,  	 . 
(Signed.)	A.B., a registrar of births and deaths.


Fee $110.(Amended 9 of 1957 s. 3; 1 of 1965 s. 12; 48 of 1975 s. 7; 67 of 1984 s. 10; 51 of 1986 s. 7; L.N. 497 of 1995; 80 of 1997 s. 68; 8 of 2006 s. 18)


_______________





FORM 8 [section 16(1)]



Permit for removal and burial of dead body
Permission is hereby given to 	 of 	 to remove 
and bury the dead body of one called 	 from the 	 floor of

No. 	 , to 	

Dated the 	 day of 	 ,  	 . 
(Signed.)      Officer in charge.

No.             Police station.


No fee is payable for this permit. 

(Amended L.N. 51 of 1974; L.N. 497 of 1994; 8 of 2006 s. 18)


_______________





FORM 9 [section 16(2)] 

Permit for removal of dead body from Hong Kong
Permission is hereby given to 	 of 	 to remove 
from Hong Kong the dead body of one called 	. 

Dated the 	 day of 	 ,  	 . 
(Signed.)	A.B., a registrar of births and deaths.


No fee is payable for this permit. (Amended L.N. 51 of 1974; 67 of 1984 s. 10; L.N. 497 of 1994; L.N. 497 of 1995; 8 of 2006 s. 18)


_______________





FORM 10 [section 17(1)]

Certificate of Registration of Death


I, A.B., a registrar of deaths in the district of                                                        , do hereby certify that the death of                                                 has been duly registered by me on the            day of                                 ,          . 

Dated the                  day of                              ,           . 
(Signed.)	A.B., a registrar of births and deaths.


No fee is payable for this certificate(Amended L.N. 497 of 1994; L.N. 497 of 1995; 8 of 2006 s. 18)


_______________





FORM 11 [section 17(1)]

Certificate of order authorizing burial/cremation of body


I, A.B., a coroner for Hong Kong, hereby certify that I have made an order authorizing the burial/cremation of the body now shown/reported to me as the body of 	. 

Dated this 	 day of 	,  	 . 
...................................................................

Coroner

(Replaced L.N. 2 of 1968. Amended 8 of 2006 s. 18)
_______________





FORM 12 [section 17(2)]

Certificate of Registration of Death

死亡登記證明書

Registration No.

登記編號 

Surname and name of 

deceased person

死者姓名 

Sex

性別 

Age

年齡 

Date of death

死亡日期 

Date registered

登記日期 

Address at death

死亡時地址 

Signature of registrar

登記官員簽署 

This certificate must be produced on demand by a police officer to prove that the name of the person entered has been registered.

如遇警務人員索閱時，必須將此證明書出示，以證明上述人名已經登記。



NO FEE IS PAYABLE FOR THIS CERTIFICATE. 

領取此證明書無須繳費。



(Replaced L.N. 497 of 1995)
_______________





FORM 13 [section 18(a)]



Certificate of still-birth


I, A.B., registered medical practitioner in Hong Kong, hereby certify that I was in attendance at the birth of the child of Mrs. C.D. [or have examined the body of the child of Mrs. C.D.] and that such child was not born alive.

Dated the 	 day of 	 ,	.
(Signed.)       A.B., Registered medical practitioner.

(Amended 67 of 1984 s. 10; 8 of 2006 s. 18)


_______________



FORM 14



(Repealed 47 of 1997 s. 10)
_______________





FORM 15 [section 19]

Notice where coffin contains more than one body


I, A.B., hereby give you notice that in the coffin in which C.D. is brought for burial there is the body of E.F., a male [or female] lately residing at No.	.

Dated the 	 day of 	 , 	.


(Signed.)	A.B., Undertaker [or person in charge of funeral].(Amended 8 of 2006 s. 18)


_______________





FORM 16 [section 19]

Notice where coffin contains more than one body


I, A.B., hereby give you notice that in the coffin in which C.D. is brought for burial there is a body which has been found exposed and that the name and place of abode of the person whose body has been found are unknown. 

Dated the 	 day of 	 , 	 . 



(Signed.)	A.B., Undertaker [or person in charge of funeral].
(Amended 8 of 2006 s. 18)


_______________





FORM 17 [section 19]

Notice where coffin also contains the body of a child


I, A.B., hereby give you notice that in the coffin in which C.D. is brought for burial there is the body of a deceased child, name unknown [or of a still-born child] and the name and place of abode of the father [or mother] of such child are 	 and No.

Dated the 	 day of 	 , 	.


(Signed.)	A.B., Undertaker [or person in charge of funeral].(Amended 8 of 2006 s. 18)




(M.D. 854) FORM 18 [section 20(a)]

Counterfoil for

 the use of the 

Medical Attendant,

who should in all 

cases fill it up. BIRTHS AND DEATHS REGISTRATION ORDINANCE 

(Chapter 174)



PART I

MEDICAL CERTIFICATE OF

THE CAUSE OF DEATH No. of

corresponding 

entry in register 

form of deaths to 

be inserted here by

the registrar. 

To be given by the medical attendant to the person whose duty

it is to give it, with information of the death,

to a registrar and to no other person 

____




Name of 

Deceased ............ 

Age ....................



Last seen ...........



Died on ..............



At ...................... ___________



I HEREBY CERTIFY that I attended ............................. during the last illness; that such person's age was stated to be ................. that I last saw h ........... on the ............. day of .............................; that ................... died* ................ on the ...............day of..........................; at ......................... and that, to the best of my knowledge and belief the cause of h ............... death was as hereunder written. An anaesthetic, namely ............................... was administered+ ............... before the death of ........................... (or, if such was the case: No anaesthetic was administered before the death of ....................................................) ............ 

Deceased's 

nationality ....... * Should the medical attendant not feel justified in taking upon himself the responsibility of certifying the fact of death, he may here insert the words "as I am informed." 

+ Insert here how long before death the anaesthetic was administered. 

Deceased's

profession .......... CAUSE OF DEATH Approximate interval between onset and death 

Deceased's

address ...............





CAUSE OF DEATH







(a) .....................

due to (or as a consequence of) I.	Disease or condition directly leading to death.++

Antecedent causes Morbid conditions, if any giving rise to the above cause, stating the underlying condition last. (a) ..........................................due to (or as a consequence of) 

(b) ..........................................due to (or as a consequence of)


(c) ......................................... .................................







.................................







................................. (The Informant should read Parts II and III of this form.)

(b) .....................

due to (or as a consequence of)





(c) .....................

Other significant conditions II.	Other significant conditions 

contributing to 

the deaths, but 

not related to the 

disease or 

condition causing

it. ...................................





................................... ........................





......................... 

++ This does not mean the mode of dying e.g., heart failure, asthenia, etc. It means the disease, injury, or complication which caused death. 

.................... -------------------------------------------------------------------------------------------------

Deceased's nationality ....................... Dated, the ............... day of .......................................

"     profession ........................ Signature .....................................................................

"     address ............................. Registered qualification ............................................

.................... "     place of death .................. Residence ...................................................................

Signed ................







Date .................. N.B.-THIS CERTIFICATE IS INTENDED SOLELY FOR THE USE OF THE REGISTRAR to whom it should be delivered by the person giving information to him of the particulars required by law to be registered concerning the death. Fine of $1000 or 6 months' imprisonment for neglect of informant to deliver this certificate to the registrar or a district registrar.

The Registrar of Births and Deaths cautions all persons against accepting or using this certificate for any purpose whatever except that of delivering it to himself or a district registrar.[OVER]

PART II
NOTICE-DUTIES UNDER THE BIRTHS AND DEATHS

REGISTRATION ORDINANCE (CAP 174)


By section 20 of the Births and Deaths Registration Ordinance, Chapter 174, it is enacted that whenever a registered medical practitioner has been in attendance during the last illness of a deceased person such practitioner shall, subject to the following qualification, sign and give to a qualified informant of the death a certificate of the cause of death, and including a statement as to whether any, and if so what, anaesthetic was administered during the said illness. The qualification is that the said practitioner shall not sign the certificate unless he has personally viewed the body of that person and is satisfied that death has occurred or, if the death has occurred in a hospital, he has received a notice from another registered medical practitioner stating that the other practitioner has personally viewed that body and is satisfied that death has occurred. The informant is bound to deliver the certificate to a registrar. 

Persons qualified to be informants for the registration of the death, and to whom

only this certificate should be given- 


1	A RELATIVE of the deceased present at the death. 



2	A RELATIVE of the deceased in attendance during the last illness. 

 

3	A person present at the death. 

 

4	A person in attendance during the last illness. 

 

5	The occupier of the house in which the death occurred. 

 

6	An inmate of the house in which the death occurred. 

 

7	The person causing the body of the deceased to be buried. 



Penalty for failing to give information within the 24 hours (in which travelling time and general holidays as defined by the General Holidays Ordinance (Chapter 149) shall not be included) next following death is $1000 fine or 6 months' imprisonment.



Informants must be prepared to state accurately to the registrar or a district registrar the following particulars- 

(1)	the date and place of death; 



(2)	the surname and full names of deceased;



(3)	the correct age of deceased; and 



(4)	the rank, profession, or occupation of deceased and nationality so far as is known. [If deceased is a child or an unmarried person without occupation or property the full names and rank or profession of the father will be required (except in the case of illegitimate children); if a wife or widow those of the husband or deceased husband.] 


_______________



PART III



NOTICE-DUTIES UNDER THE CORONERS

ORDINANCE (Cap 504)



1.	By section 4 of, and Part 2 of Schedule 1 to, the Coroners Ordinance (Cap 504), it is enacted that where the death to which a certificate of the cause of death relates is a reportable death within the meaning of that Ordinance, the registered medical practitioner who-(a)	signs that certificate;

(b)	if no such certificate is so signed, attended the deceased during his last illness,
comes under a duty to make a report of that death to the coroner as soon as is reasonably practicable after it comes to the knowledge of the practitioner that the death is a reportable death and submit a copy of the report to the Commissioner of Police at the same time.
2.	The various types of reportable deaths are specified in Part 1 of Schedule 1 to the Coroners Ordinance (Cap 504). They are-(1)	Any death of a person where a registered medical practitioner is unable to accurately state the medical cause of the death in the certificate of the cause of death.

(2)	Any death of a person (excluding a person who, before his death, was diagnosed as having a terminal illness) where no registered medical practitioner has attended the person during his last illness within 14 days prior to his death.

(3)	Any death of a person where an accident or injury (sustained at any time) caused the death.

(4)	Any death of a person where a crime or suspected crime caused the death.

(5)	Any death of a person where-(a)	an anaesthetic caused the death;

(b)	the person was under the influence of a general anaesthetic at the time of the death; or

(c)	the death occurred within 24 hours after the administering of a general anaesthetic.
(6)	Any death of a person where-(a)	an operation, whether or not lawful, caused the death; or

(b)	the death occurred within 48 hours after a major operation (as determined in accordance with prevailing medical practice), whether or not lawful.
(7)	Any death of a person where-(a)	the death was caused by-(i)	an occupational disease, within the meaning of section 3 of the Employees' Compensation Ordinance (Cap 282); or

(ii)	pneumoconiosis, or mesothelioma, within the meaning of section 2(1) of the Pneumoconiosis and Mesothelioma (Compensation) Ordinance (Cap 360), or both of those diseases; or  (Replaced 6 of 2008 s. 43)
(b)	having regard to the nature of the last illness of the person, the medical cause of the death and the nature of any known occupation or employment, or previous occupation or employment, of the person, it is reasonable to believe that the death may be connected, either directly or indirectly, with any such occupation or employment.
(8)	Any still birth where-(a)	there is doubt as whether the still born foetus was alive or dead at the time of birth; or

(b)	there is a suspicion that the still birth might not have been a still birth but for the wilful act or neglect of any person.
(9)	Any death of a woman where the death occurred within 30 days after-(a)	the birth of her child;

(b)	an operation of abortion, whether or not lawful; or

(c)	a miscarriage.
(10)	Any death of a deceased where-(a)	septicaemia caused the death; and

(b)	the primary cause of the septicaemia is unknown.
(11)	Any death of a person where there is a suspicion the death was caused by suicide.

(12)	Any death of a person where the death occurred whilst the person was in official custody.

(13)	Any death of a person where the death occurred during the course of the discharge of his duty by a person having statutory powers of arrest or detention.

(14)	Any death of a person where the death occurred in the premises of a department of the Government any public officer of which has statutory powers of arrest or detention.

(15)	Any death of a person where the person-(a)	is a patient, within the meaning of section 2 of the Mental Health Ordinance (Cap 136), and the death occurs in a mental hospital within the meaning of that section; or

(b)	is a patient the subject of an order under section 31 or 36 of that Ordinance and the death occurs in a hospital other than such a mental hospital.
(16)	Any death of a person where the death occurred in any premises in which the care of persons is carried on for reward or other financial consideration (other than in any premises which comprise a hospital, nursing home or maternity home registered under the Hospitals, Nursing Homes and Maternity Homes Registration Ordinance (Cap 165)).

(17)	Any death of a person where the death was caused by homicide.

(18)	Any death of a person where the death was caused by the administering of a drug or poison by any other person.

(19)	Any death of a person where ill-treatment, starvation or neglect caused the death.

(20)	Any death of a person which occurred outside Hong Kong where the body of the person is brought into Hong Kong.
3.	Subject to certain defences, under the Coroners Ordinance (Cap 504), a registered medical practitioner who fails to discharge the duty referred to in paragraph 1 commits an offence under that Ordinance and may thereby render himself liable to a fine at level 1 and to 14 days imprisonment under that Ordinance.

(Replaced G.N.A. 318 of 1948. Amended 9 of 1957 s. 3; L.N. 214 of 1974 ; L.N. 497 of 1995; 27 of 1997 s. 74. Part III added 27 of 1997 s. 74. Amended 80 of 1997 s. 68; 35 of 1998 s. 5; 21 of 1999 s. 28; 8 of 2006 s. 18)


_________________





FORM 19 [section 27(c)]

Declaration for correction of error in register 


We, A.B., of ................................................................................................................ 

and C.D., of ......................................................................................................................... 

solemnly and sincerely declare that when the birth (or death) of E.F. was registered on the ................. day of ....................................., the following errors of fact or substance occurred in the register, viz., 

(here set forth the error or errors). 



And we further solemnly and sincerely declare that the true facts of the case are as follows:-

(here set forth the true facts).





And we make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Ordinance (Cap 11). 

(Signed)              A.B. 
C.D. 


Declared at ..................................................................................................... in Hong Kong this ..................... day of .....................................

Before me, 
(Signed) 
registrar. 

(Replaced L.N. 214 of 1974. Amended L.N. 497 of 1994; L.N. 497 of 1995; 8 of 2006 s. 18)

[Index] [Table] [Search] [Notes] [Noteup] [Previous] [Next] [Download (Current & Past)] [Download (Current only)] [繁體中文] [Help]

Registration No. 登記編號
When and where born 出生日期及地點
Name, if any 名字(如有的話)
Sex 性別
Surname and name of father 父親姓名
Maiden surname and name of mother 母親婚前姓氏及名字
Signature, description and residence of informant 申報人簽署、身分及住址
When registered 登記日期
Signature of registrar 登記官員簽署
Name, if added after registration of birth 名字 (如在出生登記後加上)
Status of permanent resident of the Hong Kong Special Administrative Region under the Immigration Ordinance (Cap 115) (Established/Not established) 《入境條例》(第115章) 下的香港特別行政區永久性居民身分 (確定/未確定)

Registration No. 登記編號
When and where died 死亡日期及地點
Surname and name 姓名
Sex 性別
Age 年齡
Rank, profession, or occupation and nationality so far as is known 所知的職位或職業及國籍
Cause of death 死因
Signature, description and residence of informant 申報人簽署、身分及住址
When registered 登記日期
Signature of registrar 登記官員簽署

Registration No. 登記編號
Surname and name of child 出生者姓名
Sex 性別
Date of birth 出生日期
Date registered 登記日期
Maiden surname and name of mother 母親婚前姓氏及名字
Address at birth 出生時地址
Signature of registrar 登記官員簽署

(Strike out either (a) or (b) as required.)	(a) to add the name(s) of .................................................................... to the above-mentioned name(s).
	(b) to alter the above-mentioned name(s) to .......................................... .....................................................................................................

Registration No. 登記編號
Surname and name of deceased person 死者姓名
Sex 性別
Age 年齡
Date of death 死亡日期
Date registered 登記日期
Address at death 死亡時地址
Signature of registrar 登記官員簽署

(M.D. 854)		FORM 18		[section 20(a)]
Counterfoil for the use of the Medical Attendant, who should in all cases fill it up.	BIRTHS AND DEATHS REGISTRATION ORDINANCE (Chapter 174) PART I MEDICAL CERTIFICATE OF THE CAUSE OF DEATH			No. of corresponding entry in register form of deaths to be inserted here by the registrar.
	To be given by the medical attendant to the person whose duty it is to give it, with information of the death, to a registrar and to no other person
____ Name of Deceased ............
Age .................... Last seen ........... Died on .............. At ......................	___________ I HEREBY CERTIFY that I attended ............................. during the last illness; that such person's age was stated to be ................. that I last saw h ........... on the ............. day of .............................; that ................... died* ................ on the ...............day of..........................; at ......................... and that, to the best of my knowledge and belief the cause of h ............... death was as hereunder written. An anaesthetic, namely ............................... was administered+ ............... before the death of ........................... (or, if such was the case: No anaesthetic was administered before the death of ....................................................) ............
Deceased's nationality .......	* Should the medical attendant not feel justified in taking upon himself the responsibility of certifying the fact of death, he may here insert the words "as I am informed." + Insert here how long before death the anaesthetic was administered.
Deceased's profession ..........	CAUSE OF DEATH		Approximate interval between onset and death
Deceased's address ............... CAUSE OF DEATH (a) ..................... due to (or as a consequence of)	I. Disease or condition directly leading to death.++ Antecedent causes Morbid conditions, if any giving rise to the above cause, stating the underlying condition last.	(a) .......................................... due to (or as a consequence of) (b) .......................................... due to (or as a consequence of) (c) .........................................	................................. ................................. .................................	(The Informant should read Parts II and III of this form.)
(b) ..................... due to (or as a consequence of) (c) ..................... Other significant conditions	II. Other significant conditions contributing to the deaths, but not related to the disease or condition causing it.	................................... ...................................	........................ .........................
	++ This does not mean the mode of dying e.g., heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.
....................	~~-------------------------------------------------------------------------------------------------~~ Deceased's nationality ....................... Dated, the ............... day of .......................................
	" profession ........................ Signature .....................................................................
	" address ............................. Registered qualification ............................................
....................	" place of death .................. Residence ...................................................................
Signed ................ Date ..................	N.B.-THIS CERTIFICATE IS INTENDED SOLELY FOR THE USE OF THE REGISTRAR to whom it should be delivered by the person giving information to him of the particulars required by law to be registered concerning the death. Fine of $1000 or 6 months' imprisonment for neglect of informant to deliver this certificate to the registrar or a district registrar. The Registrar of Births and Deaths cautions all persons against accepting or using this certificate for any purpose whatever except that of delivering it to himself or a district registrar. [OVER]