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____________________________________ ga
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(FHDY organi nomi)
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_________________________________
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(ariza beruvchi(lar)ning familiyasi, ismi, ota ismi)
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_________________________________
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(yashash manzili)
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_________________________________
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(pasport seriyasi, raqami, qachon, kim tomonidan berilgan)
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ARIZA
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Mening (bizning) _______ yil ___________ oyi ______ kunida tug‘ilgan farzandim(iz)ning tug‘ilishini__________________________________________________________________________________________________________________________________ sababli
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(o‘z vaqtida qayd ettirmaganlik sababi ko‘rsatilsin)
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o‘z vaqtida qayd ettira olmaganligim(iz) tufayli, uning familiyasini_____________________ ismini _____________________ ota ismini ____________________________ deb ko‘rsatib,
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tug‘ilishini qayd etib, guvohnoma berishingizni so‘rayman (so‘raymiz).
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Ilova:
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1. Tug‘ilganligi haqida tibbiy ma’lumotnoma
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2. Sog‘lig‘i to‘g‘risida ma’lumotnoma
| |
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3. _____________________________
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4. _____________________________
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________________________
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_____ yil “___” ___________
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(ariza beruvchi(lar)ning imzosi)
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