Field marked With *are Compulsory!

Child Name : *		Hospital Name : *
Gender : *	Select Male Female	Address : *
Date of Birth : *
Father Name : *		Mother Name : *
Father Education :		Mother Education :
Father Occupation :		Mother Occupation :
Mother Age on Marriage :		Mother Age on Delivery :
No. of Born Child :		Child Weight :
Challan Number : *		Challan Date : *