How To Register An Out-of-Hospital Birth
How to Register anOut-of-HospitalBirth(805) 781-5514Please call for anappointment to register your baby’s birth.When a birth occurs outside a hospital, the physician or midwife whoattended the birth – or in the absence of a physician or midwife, theparents – must register the birth.This packet contains an important worksheet which the physician,midwife, or parents must complete and take to their local healthdepartment within 10 days of the birth. This worksheet and affidavitwill be used to register the baby’s birth.January 2014
Table of ContentsPageCongratulations to Parents1Letter to Physician or Midwife2Questions Frequently Asked by Parents4Instructions for Registering the Birth8AttachmentsWorksheet for Out-of-Hospital BirthsAffidavit of Birth Information for Out-of-Hospital BirthsCertificate of Live Birth – Medical DataSupplemental Worksheet (VS 10A)Race Identification WorksheetWeight Conversion TableWhat You Need to Know About Your Child’sBirth Certificate – EnglishWhat You Need to Know About Your Child’sBirth Certificate – SpanishOut of Hospital Birth Packet
Dear Parents:Congratulations to you and your newborn baby!We want to help you register your baby’s birth and geta birth certificate. We are offering this help because youdid not give birth in a hospital – where hospital staffwould have registered the birth. If a physician or certifiednurse midwife / licensed midwife attended the birth, he orshe may help you complete the enclosed worksheet.Please read this pamphlet very carefully. It will walkyou through the process of registering your baby’s birth.This pamphlet includes a worksheet that must becompleted and taken to your local health departmentwithin 10 days of the birth.Chief Deputy RegistrarVital Records-1-
Dear Physician or Midwife:We understand you recently attended the birth of a child outside of a hospital.Health and Safety Code Section 102415 requires that you register the birth ofthis child with the local health department.This pamphlet provides instructions on how to register the birth. It also containsan important worksheet that must be completed to register the birth.1.Please read the pamphlet carefully, complete the Worksheet forOut-of-Hospital Births, the Affidavit of Birth Information for Out-of-HospitalBirths, and gather the necessary documents related to the birth.2.Call our office to schedule an appointment to register the birth (the phonenumber is on the cover of this pamphlet).3.Share the worksheet with the parent(s) of the child prior to the registrationappointment so they can help in gathering worksheet information.4.Please advise the parents that they need to visit this office to sign the birthcertificate. Although we suggest that the parents sign the certificate at thetime of the appointment, a separate appointment can be made toaccommodate their schedule.The birth will not be registered until all signatures are in place.By law, the birth certificate must be registered within 10 days of the birth(Health and Safety Code Section 102400).The following page provides options available for registering the birth.Thank you for your time and help in registering the birth of this child.Chief Deputy RegistrarVital Records-2-
Physicians and Midwives: Following are different options that are available forregistering the birth of the child:If . . .You want yoursignature and typedname and title on thebirth certificateThen . . .1. Fill out the Worksheet for Out-of-Hospital Births and Affidavit ofBirth Information for Out-of-Hospital Births (attached) and bringthem to your appointment.2. Call our office to schedule an appointment to come in andcomplete your portion of the certificate.3. Inform the parents that they need to come to our office tosign the certificate. They can come in at the same time as you,or a separate appointment can be made to accommodate theirschedule.You want your typedname and title on thebirth certificate1. Fill out the Worksheet for Out-of-Hospital Births and Affidavit ofBirth Information for Out-of-Hospital Births (attached) and givethem to the parents.(But your signature willnot be included)2. Refer the parents to the instructions in this pamphlet.3. Instruct the parents to bring your signed Affidavit and otherevidence to prove the five facts listed below to our office toregister the birth:a.b.c.d.Identity of parent(s)Pregnancy of the motherBaby was born aliveBirth occurred in the county where thebirth certificate is to be registerede. Identity of the witnessNote: The signed Affidavit from a physician or midwife issufficient evidence to prove b, d, and e, but the parents will stillneed to provide evidence for facts a and c.4. Upon review and acceptance of the Affidavit, the clerk will typeyour name and title on the birth certificate (item 13D). However,the signature box (item 13A) will state “Unavailable.”You do not want yoursignature or typedname and title on thebirth certificate1. Refer the parents to the instructions in this pamphlet.2. Inform the parents that without a signature from a physician ormidwife on the birth certificate, they will need to provideevidence of the five facts listed above.-3-
Questions Frequently Asked by ParentsWhy do I need toregister my baby’sbirth?You need to register your baby’s birth to comply with state law.Registering the birth is the only way to create a permanent legal recordof the birth. For babies not born in a hospital, California law requires thephysician or midwife who attended the birth – or in the absence of aphysician or midwife, either one of the parents – to register the birth of ababy born in California (Health and Safety Code Section 102415).You also need to register the birth to obtain an official birth certificate.During your child’s life, he or she will need an official birth certificate(certified copy) to: Obtain a Social Security Number Enroll in School Register to Participate in Sports Apply for a Driver’s License Travel or Obtain a Passport Apply for Various Benefits(Social Security, Military)Birth certificates are also valuable to establish: Proof of Parentage Identity Inheritance Rights CitizenshipA certified copy of a birth certificate is a legal record of your child’sbirth. Certified copies are recognized in any court.When should Iregister mybaby’s birth?By law, you must register the birth of your baby within 10 days ofthe birth (Health and Safety Code Section 102400). There is no feeto register the birth within the first year.Any birth registered on or after the child’s first birthday must beprocessed by California Department of Public Health Vital Records as aDelayed Registration of Birth (there is a 23 registration fee after the firstyear). If you cannot meet the requirements for a Delayed Registration ofBirth, you will have to apply to your local Superior Court for a Court OrderDelayed Registration of Birth. Out-of-hospital births are harder to registerthe longer you wait after the date of the birth.Who shouldregister my baby’sbirth?When a baby is born at home or elsewhere outside a hospital, thephysician or midwife who attended the birth – or in the absence of aphysician or midwife, either one of the parents – is responsible forregistering the birth with the local health department in the county wherethe birth occurred.-4-
How can I makesure the certificate iscompleted correctly?Please review your baby’s birth certificate for accuracy beforesigning it. Never sign a blank birth certificate – the person completing itmay make errors. Once the record has been registered, any corrections(such as misspellings or omissions) must be made through CaliforniaDepartment of Public Health Vital Records, and a fee may be charged.The processing time for amendments can be located on our website ges/ProcessingTimes.aspxWhat if there is anerror on the birthcertificate?After your baby’s birth certificate has been registered, the originalcertificate (with the exception of gender error) cannot be changed. Errorscan only be corrected by filing an Affidavit to Amend a Record (VS 24form), which is available from your local health department, or fromCalifornia Department of Public Health Vital Records.(Refer to theattached flyer,“What You Needto Know AboutYour Child’sBirth Certificate”)When accepted, the affidavit will be attached to the original certificateand will become part of the legal birth record (the birth certificate willbecome a two-page document – the original birth certificate, and theaffidavit). The original certificate is not changed.If there is a gender error on the birth certificate, contact your local healthdepartment for instructions on how to correct the error.What if part (or all)of my baby’s namewas left off the birthcertificate?After your baby’s birth certificate has been registered, the originalcertificate cannot be changed. If part (or all) of the baby’s name wasleft off the birth certificate, and you want to add the baby’s name, youmust complete either a Supplemental Name Report – Birth (VS 107 form),or an Affidavit to Amend a Record (VS 24 form). These forms areavailable from your local health department, or from California Departmentof Public Health Vital Records.When accepted, the application or affidavit will be attached to the originalcertificate and will become part of the legal birth record (the birthcertificate will become a two-page document). The original certificate isnot changed.Note: If you want to change your child’s name after the birth has beenregistered, you may need to obtain a court order.For amendments made within one year of the child’s birth, there is noprocessing fee. For amendments made one year or more after thechild’s birth, there is a 23 processing fee.-5-
How can I get acertified copy of thebirth certificate?You will not automatically receive a copy of your baby’s birth certificate.Once the birth is registered, you can request a certified copy of the birthcertificate from the Local Health Department or County Recorder in thecounty where your child was born, or from California Department ofPublic Health Vital Records.A fee is charged for each certified copy requested.How can I get aSocial Securitynumber for mychild?You can get a Social Security number for your child by contacting thenearest Social Security office. There is never a charge for a socialsecurity number and card from the Social Security Administration. Formore information about Social Security, contact your nearest SocialSecurity Office or call (800) 772-1213 (toll-free). This phone number willprovide you with prerecorded information at any time – attendants areavailable only from 7 a.m. to 7 p.m. (Pacific Standard Time) on anybusiness day. You can also access Social Security’s website at:www.socialsecurity.gov.Who collects theinformation on thebirth certificate?The information you enter on the enclosed worksheet will be transferredto the Certificate of Live Birth (VS 10D) and collected by the CaliforniaDepartment of Public Health, Vital Records. This information is requiredby Division 102 of the Health and Safety Code.Am I required tocomplete every partof the worksheet?You must complete each field of information on the Worksheet forOut-of-Hospital Births, except for the fields between the double bold linesin the center of the front page. We ask that you provide this optionalinformation as well, so that the records are complete – but you are notrequired to do so. The information marked “medical data” will not betranscribed onto the actual hard copy of the birth certificate. Thisinformation will also not be disclosed or available to anyone except to theCalifornia Department of Public Health and the federal government andwill be used for demographic and statistical analysis only without anypersonal identifying information. (Health and Safety Code Section102426.)The voluntary fields, which apply to information for both the mother andfather, are: Race and Ethnicity Education Usual Kind of Business or Industry(Continued)-6- Usual Occupation Social Security Numbers Date Last Worked
Am I required tocomplete every partof the worksheet?For births not attended by a physician or midwife, there are also threevoluntary fields (see asterisks on the worksheet) which apply to medicaldata:(Continued) Complications and procedures of pregnancy and concurrent illnesses Complications and procedures of labor and delivery, and Abnormal conditions and clinical procedures related to the newbornThese three fields are required for physician- or midwife-attended births.They are, however, voluntary if the parents are registering the birth.What is theinformation onthe birth certificateused for?The California Department of Public Health collects birth information forconducting research relating to the health status of California’spopulation.-7-
Instructions for Registering the BirthAction requiredbefore appointmentwith local healthdepartmentComplete the enclosed “Worksheet for Out-of-Hospital Births”before your appointment with the local health department.The enclosed worksheet will be used to register the baby’s birth andprepare the birth certificate. Fill out the worksheet accurately with factsas of the day the baby was born. We prefer that all items be completedor accounted for, including the public health data portion of theworksheet.If the birth was attended by a physician or midwife, he or she shouldcomplete form VS 10A (attached), which provides supplemental medicalinformation.Contact our office if you have any questions regarding registering yourbaby’s birth.Declaration ofPaternityIf the mother and father are not married to each other, the father’s namecannot be listed on the birth certificate unless both the mother and fathersign a voluntary Declaration of Paternity (CS 909) before the birthcertificate is prepared.Call the Department of Child Support Services (1-866-249-0773) or yourlocal health department if you have any questions or need to obtainforms.EvidencerequiredThis section applies only if a physician or midwife was not inattendance at the birth, and the parents are registering the birth.Please bring to your appointment evidence to prove five facts:1.2.3.4.5.Identity of the parent(s)Pregnancy of the motherBaby was born aliveBirth occurred in CaliforniaIdentity of the witnessAdditional information about these five items is provided below.(Continued)-8-
Evidencerequired(Continued)Identity of the ParentsA valid picture identification card issued to the parents by a governmentagency must be provided to prove identity. Following are somerecommended documents that can be used (only the original or acertified copy is acceptable): A driver’s license or identification card issued by a United States(U.S.) Department of Motor Vehicles Office. U.S. passport. U.S. military identification card. Temporary resident identification card (green card). Other valid picture identification card issued by a foreigngovernment. (If the parents gave birth in California but are nothere legally, they may be able to get identification verificationfrom their consulate.)Pregnancy of the MotherTo prove the pregnancy of the mother, provide a pregnancy testverification form or a letter that meets all of the following conditions: From a doctor, midwife, or clinic. Written on the doctor’s, midwife’s, or clinic’s official stationery(not on a prescription pad). Signed (not stamped) by the doctor, midwife, or clinicrepresentative or nurse. Contains the current issued professional license number of thephysician or midwife who signed the letter.The letter must include all of the following information: The mother’s name. The date the mother was first seen by the doctor or midwife(this date may be after the date of birth). The results of the mother’s prenatal or postpartum exams orpregnancy tests.(Continued)-9-
Evidencerequired(Continued) The date of the mother’s last menstrual period. The date the baby was born, or was expected to be born (duedate).Baby was Born Alive Bring the baby to the appointment. The appointment will not be conducted if the baby is notpresent.Birth Occurred in CaliforniaWe need information showing that the mother was in California on thedate that the birth occurred. Documentation to confirm the mother’spresence in California on the date the birth occurred may include anyof the following: If the birth occurred at the mother’s residence, provide an electricpower, natural gas, or water bill for the period when the birthoccurred. The copy of the bill (or statement from the company)must include the name of the utility company, the address of theresidence where the birth occurred, and the name of the motheror father (if he is listed on the birth certificate). An affidavit from someone who was with the mother at the timeof the baby’s birth. The affidavit must contain the address of theperson with the mother, and the location of the birth. A current rent receipt or other similar document that shows themother’s name and current address. A statement from a state or local government agency thatrequires proof of residency in California that the mother wasreceiving services on the date of the baby’s birth (e.g., WIC orMedi-Cal).Identity of the WitnessIf a physician or midwife did not attend the birth, and if a witness didattend, the witness should accompany you to the appointment.A witness may include any of the following: Spouse or other family member. Friend.(Continued)-10-
Evidencerequired Paramedic or fire department staff.If a paramedic or fire department staff was present at the birth,you can get a copy of the official report stating the treatment orservice they provided (there may be a fee for the report.) Thestaff does not have to be present at the appointment, nor do youhave to bring a copy of their identification.(Continued)If the paramedic arrived after the baby’s birth, bring a copy of the911 call or an official report of the contents of the 911 call, alongwith a copy of the paramedic’s report. If the paramedic cut the cord, or was present when thecord was cut, the report should so state. If the paramedic delivered the placenta, the report shouldso state.Valid ID for Witness: A valid picture identification card issued to thewitness by a government agency must be provided to prove identity.Following are some recommended documents that can be used (onlythe original or a certified copy is acceptable): A driver’s license or identification card issued by a United States(U.S.) Department of Motor Vehicles Office. U.S. passport. U.S. military identification card. Temporary resident identification card (green card). Other valid picture identification card issued by a foreigngovernment. (If the witness is not in California legally, he or shemay be able to get identification verification from their consulate.)VerificationThe local health department may verify the accuracy of all informationprovided to register an out-of-hospital birth.Registrar’s rightto refuse to registerbirthIf the requirements of Health and Safety Code Section 102415 and ofthe enclosed registration packet or other bona fide evidence are notpresented to the registrar, then the registrar must refuse to register thebirth certificate. In these cases, the birth certificate may be registeredonly by authority of a Superior Court. (Health and Safety Code Section103450.)-11-
Valid ID forphysician/midwifeThe physician or midwife must provide written documentation of theiridentity at the time they sign the birth certificate.A valid picture identification card issued by a government agencymust be provided to prove identity. Following are some recommendeddocuments that can be used (only the original or a certified copy isacceptable): A driver’s license or identification card issued by a United States(U.S.) Department of Motor Vehicles Office. U.S. passport. U.S. military identification card.The physician or midwife must also provide their professional licensenumber for verification purposes.-12-
Worksheet for Out-of-Hospital BirthsPlease Bring This Completed Form to Register Your Child’s Out-of-Hospital BirthChild’sInformationFirst NameMiddleLastSexThis BirthDate of BirthTime of BirthPlace of BirthStreet AddressCityCountyFather/Parent’sInformationFirst NameMiddleState of BirthDate of BirthMother/Parent’sInformationFirst NameMiddleState of BirthDate of BirthSpecify 1 Single, 2 Twin, 3 Triplet, Etc. a.m. p.m.ZipLast (Birth)Last (Birth)The Following is Confidential Information and Will be Used for Public Health Purposes nformationRace (list up to 3)Hispanic: Yes NoSee Attached Race/Ethnicity WorksheetSpecify:Usual OccupationUsual Kind of Business or IndustryEducation – Years CompletedRace (list up to 3)Hispanic: Yes NoSee Attached Race/Ethnicity WorksheetSpecify:Usual OccupationUsual Kind of Business or IndustryEducation – Years CompletedResidence – Street Name and NumberCountyCityStateMailing Address – If Different From Residence AddressStreet Name and Number or P.O. BoxCountyCityState/Foreign CountyContinued on BackDate Last WorkedSocial Security NumberDate Last WorkedSocial Security NumberZipZip
Worksheet for Out-of-Hospital Births (Continued)The Following is Confidential Information and Will be Used for Public Health Purposes OnlyMedicalDataDid Mother Receive WIC (Womens, Infants & Children) Food While Pregnant?Average Number of Cigarettes/Packs Per DayFirst Three Months Prior to PregnancyAverage Number of Cigarettes/Packs Per DayFirst TrimesterAverage Number of Cigarettes/Packs Per DaySecond TrimesterAverage Number of Cigarettes/Packs Per DayThird TrimesterPrepregnancy Weight in PoundsDelivery Weight in PoundsHeight FeetHeight InchesAPGAR Score at 1 MinuteAPGAR Score at 5 MinutesAPGAR Score at 10 MinutesDate Last Normal Menses Began(00-10, Unknown, or Not Taken)(00-10, Unknown, or Not Taken)(00-10, Unknown, or Not Taken)Date First Prenatal Care VisitMonth Prenatal Care BeganDate Last Prenatal Care VisitObstetric Estimate of Gestation at Delivery(Completed Weeks)Number of Prenatal VisitsHearing Screening: (Pass (Both Ears); Refer (One Ear); Refer(Both Ears); Results Pending; Waived; Not Medically Indicated;Test Not Available)PREGNANCY HISTORY (Complete Each Section)Live Births (Do not count this child)Other Terminations (Exclude induced abortions)Now LivingBefore 20 WeeksNow DeadDate of Last Live BirthEnterAppropriateCodes FromWorksheetsAfter 20 WeeksDate of Last Other TerminationPrincipal Source of Paymentfor Prenatal CareBirthweight in Grams (See attachedbirth weight conversion table)Principal Source of Paymentfor Delivery* Complications and Procedures of Pregnancy and Concurrent Illnesses (See attached VS 10Aworksheet) Enter 00 for NONE* Complications and Procedures of Labor and Delivery(See attached VS 10A worksheet) Enter 00 for NONEMethod of Delivery (See attached VS 10A worksheet)* Abnormal Conditions and Clinical Procedures Related to theNewborn (See attached VS 10A worksheet) Enter 00 for NONE* The attending physician or midwife shall complete these three fields for physician- or midwife-attended out-of-hospital births.These three fields are optional for non-physician- or non-midwife-attended out-of-hospital births.
Affidavit of Birth Information for Out-of-Hospital BirthsThis Affidavit is to be Completed at the Local Health OfficeI swear or affirm that the information stated is true and correct to the best of my knowledge and belief. I certify that thechild named herein was born alive to the stated mother at the place, date, and time shown on this worksheet.This worksheet was completed with the understanding that the facts so stated herein afford a full, complete, and truthfulrepresentation of facts and what my testimony shall be should I be asked or directed to testify to the facts herein in a courtof law. I realize that any false statement of facts or information made herein could subject me to the risk of criminalliability, including, but not limited to, prosecution for ed NameWritten Signature Relationship to Child Mother/Parent Father/ParentPrinted NameDate SignedPhone Number(Written Signature Address – Street Name and NumberCountyCityStateRelationship to ChildAttendantVerificationZipDate SignedPrinted NamePhone Number()Written Signature Address – Street Name and Number(Physician,Certified NurseMidwife, orLicensedMidwife)LocalRegistrationDistrict StaffVerificationCountyCityState License Number)StateZipDate SignedPrinted NamePhone Number()Written Signature Date SignedInventory Control Number Registered DeniedPrivacy NotificationThe information entered on the worksheet will be transferred to the Certificate of Live Birth (VS 10D) and willbe collected by the California Department of Public Health Vital Records, 1501 Capitol Avenue, M.S. 5103,P.O. Box 997410, Sacramento, CA 95899-7410, telephone number (916) 445-2684. This information isrequired by Division 102 of the Health and Safety Code. Every element on the worksheet is mandatory, exceptthe items between the double bold lines on the first page of the worksheet. Failure to comply by every person,except a parent informant, is a misdemeanor. The Certificate of Live Birth is open to public access exceptwhere prohibited by statute. The principal purposes of this record are to: 1) Establish a legal record of each vitalevent, 2) Provide certified copies for personal use, 3) Furnish information for demographic and epidemiologicalstudies, and 4) Supply data to the National Center for Health Statistics for federal reports. The father’s and themother’s Social Security numbers are included pursuant to Section 102425 (b) (14) of the Health and SafetyCode, and may be used for child support enforcement purposes.March 3, 2008
State of California-Health and Human Services AgencyDepartment of Public HealthCERTIFICATES OF LIVE BIRTH AND FETAL DEATHMEDICAL DATA SUPPLEMENTAL WORKSHEETVS 10A (Rev. 1/2006)Use the codes on this Worksheet to report the appropriate entry in items numbered 25D and 28A through 31 on the“Certificate of Live Birth” and for items 29D and 32B through 35 on the “Certificate of Fetal Death.”Item 25D. (Birth)Item 29D. (Fetal Death)PRINCIPAL SOURCE OF PAYMENT FOR PRENATAL CARE(Enter only 1 code)02 Medi-Cal, without CPSP Support Services13 Medi-Cal, with CPSP Support Services05 Other Government Programs (Federal, State, Local)Item 28A. (Birth)Item 32A (Fetal Death)01 Cesarean—primary11 Cesarean—primary, with trial of labor attempted21 Cesarean—primary, with vacuum31 Cesarean—primary, with vacuum & trial of labor attempted02 Cesarean—repeat12 Cesarean—repeat, with trial of labor attempted22 Cesarean—repeat, with vacuum32 Cesarean—repeat, with vacuum & trial of labor attempted03 Vaginal—spontaneous04 Vaginal—spontaneous, after previous Cesarean05 Vaginal—forceps15 Vaginal—forceps, after previous Cesarean06 Vaginal—vacuum16 Vaginal—vacuum, after previous Cesarean88 Not Delivered (Fetal Death Only)C. Fetal presentation at birth20304090Cephalic fetal presentation at deliveryBreech fetal presentation at deliveryOther fetal presentation at deliveryUnknownD. Was vaginal delivery with forceps attempted, but unsuccessful?50 Yes58 No59 UnknownE. Was vaginal delivery with vacuum attempted, but unsuccessful?60 Yes68 No69 UnknownF. Hysterotomy/Hysterectomy (Fetal Death Only)70 Yes78 No14 Other99 Unknown00 Medically Unattended BirthCOMPLICATIONS AND PROCEDURES OF PREGNANCY AND CONCURRENT ILLNESSES(Enter up to 16 codes, separated by commas, for the most important complications/procedures.)HYPERTENSION03 Prepregnancy (Chronic)01 Gestational (PIH, Preeclampsia)02 EclampsiaOTHER COMPLICATIONS/PREGNANCIES32 Large fibroidsCOMPLICATIONS/PREGNAN33 Asthma34 Multiple pregnancy (more than 1 fetus this pregnancy)CIES35 Intrauterine growth restricted birth this pregnancyPrevious preterm birth ( 37 weeks gestation)Other previous poor pregnancy outcomes (Includesperinatal death, small-for-gestational age/intrauterinegrowth restricted birth, large for gestational age, etc.)OBSTETRIC PROCEDURES24 Cervical cerclage28 Tocolysis37 External cephalic version—Successful38 External cephalic version—Failed39 Consultation with specialist for high risk obstetric servicesPREGNANCY RESULTED FROM INFERTILITY TREATMENT40 Fertility-enhancing drugs, artificial insemination orTREATMENTintrauterine insemination41(Enter 0 – 9, or U if Unknown)05 Other Government Programs (Federal, State, Local)07 Private Insurance09 Self PayDIABETES09 Prepregnancy (Diagnosis prior to this pregnancy)31 Gestational (Diagnosis in this pregnancy)2336B. If mother had a previous Cesarean—How many?EXPECTED PRINCIPAL SOURCE OF PAYMENT FOR DELIVERY(Enter only 1 code)02 Medi-Cal15 Indian Health Service16 CHAMPUS/TRICAREItem 29. (Birth)Item 33. (Fetal Death)99 Unknown00 No Prenatal CareMETHOD OF DELIVERY(Enter only 1 code/number under each section, separated by commas: A,B,C,D,E,F)A. Final delivery routeItem 28B. (Birth)Item 32B (Fetal Death)07 Private Insurance Company09 Self Pay14 OtherINFECTIONS PRESENT AND/OR TREATED DURING THISPREGNANCY42 Chlamydia43 Gonorrhea44 Group B streptococcus18 Hepatitis B (acute infection or carrier)45 Hepatitis C16 Herpes simplex virus (HSV)46 Syphilis47 Cytomegalovirus (Fetal Death Only)48 Listeria (Fetal Death Only)49 Parvovirus (Fetal Death Only)50 Toxoplasmosis (Fetal Death Only)PRENATAL SCREENING DONE FOR INFECTIOUS DISEASES51 ChlamydiaDISEASES52 Gonorrhea53 Group B streptococcal infection54 Hepatitis B55 Human immunodeficiency virus (offered)56 SyphilisNONE OR OTHER COMPLICATIONS/PROCEDURES NOT LISTED00 NoneCOMPLICATIONS/PROCEDURE30 Other Pregnancy Complications/Procedures not ListedS NOT LISTEDAssisted reproductive technology (e.g., in vitro fertilization(IVF), gamete intrafallopian transfer (GIFT)See reverse side for codes to Birth Items 30 and 31 and Fetal Death Items 34 and 35.Do not enter any identification b
Mar 03, 2008 · baby’s birth? By law, you must register the birth of your baby within 10 days of the birth (Health and Safety Code Section 102400). There is no fee to register the birth within the first year. Any birth registered on or after the child’s first birthday must be processed by Californi
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Volume 46, Number 47 Pages 1341 - 1358 Minnesota State Register Published every Monday (Tuesday when Monday is a holiday) Minnesota Legislative Information . #51 Monday 20 June Noon Tuesday 14 June Noon Thursday 9 June. State Register Website. State Register Website (Cite 46 SR 1343) Minnesota tate Register, Monday 23 May 2022 Page 1343.
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