APPLICATION FOR BIRTH CERTIFICATE CIRCLE/LOCALITY: 1. Date of Birth: 2. Child Name: a) If Registered Mention the Child Name. b) If Child Name not included a separate form to be filled by the Father and Mother of the child 4. Name of the Father: 5. Name of the Mother: Birth certificate will be issued subject to entry found Registered. FORM NO ‐ 5 Ensure registration of every birth & death within 21 days. GOVERNMENT OF ANDHRA PRADESH, INDIA MEDICAL & HEALTH Sample Birth Certificate - From Andhra Pradesh, India in English Author: diveblue.info Subject. How to download birth certificate andhra pradesh form 5 in official website I born on my grand mother’s house as right now my age is 24 but I have no birth certificate till now date. I need to submit it in my company as to show my age proof.