| BIRTH CERTIFICATE FIELD NAME | FIELD No. |
| ABNORMAL CONDITIONS/CLINICAL PROCEDURES RELATING TO NEWBORN | 31 |
| ASSIGNED LOCAL FILE NUMBER | LFN |
| ATTENDANT CODE | TYPE |
| ATTENDANT LICENSE NUMBER | 13B |
| BABY'S PATIENT FILE NUMBER | BPF |
| BIRTH LAST (FAMILY) NAME OF MOTHER (MAIDEN SURNAME) | 9C |
| BIRTHWEIGHT | 26 |
| CENSUS TRACT | CT |
| CERTIFIER CODE | D |
| CITY OR TOWN OF BIRTH | 5C |
| COMMENT | COM |
| COMPLICATION OF PREGNANCY AND CONCURRENT ILLNESSES | 29 |
| COMPLICATIONS OF LABOR AND DELIVERY | 30 |
| COUNTY OF BIRTH | 5D |
| COUNTY OF OCCURRENCE CODE | I5D |
| DATE ACCEPTED FOR REGISTRATION | 17 |
| DATE ATTENDANT OR CERTIFIER SIGNED | 13C |
| DATE INFORMANT SIGNED | 12C |
| DATE LAST NORMAL MENSES BEGAN | 25A |
| DATE OF BIRTH | 4A |
| DATE OF DEATH | 15A |
| DATE OF LAST LIVE BIRTH | 27C |
| ELECTRONIC TRANSFER DATE | SENT1 |
| FATHER HISPANIC | 19 |
| FATHER'S AGE AT CHILD'S BIRTH | FAGE |
| FATHER'S DATE OF BIRTH | 8 |
| FATHER'S RACE | 18 |
| FATHER'S RACE CODE | I18 |
| FATHER'S SOCIAL SECURITY NUMBER | 32 |
| FATHER'S SPANISH CODE | I19 |
| FATHER'S STATE OF BIRTH | 7 |
| FATHER'S USUAL KIND OF BUSINESS OR INDUSTRY | 20B |
| FATHER'S USUAL OCCUPATION | 20A |
| FIRST (GIVEN) NAME OF CHILD | 1A |
| FIRST (GIVEN) NAME OF FATHER | 6A |
| FIRST (GIVEN) NAME OF MOTHER | 9A |
| GESTATIONAL AGE | GAGE |
| GESTATIONAL AGE IN WEEKS | GAWK |
| HOSPITAL CODE | I5A |
| HOUR OF BIRTH (24 HOUR CLOCK) | 4B |
| INFORMANT'S RELATIONSHIP TO CHILD | 12B |
| INTERNAL STATE OF FATHER'S BIRTH CODE | I7 |
| INTERNAL STATE OF MOTHER'S BIRTH CODE | I10 |
| INTERNAL STATE OF RESIDENCE CODE | I24D |
| ISSUE SOCIAL SECURITY NUMBER? | SSA1 |
| LAST (FAMILY) NAME OF CHILD (SURNAME) | 1C |
| LAST (FAMILY) NAME OF FATHER (SURNAME) | 6C |
| LOCAL REGISTRAR SIGNATURE | 16) |
| MARITAL STATUS | MSTAT |
| METHOD OF DELIVERY | 28A |
| MIDDLE NAME OF CHILD | 1B |
| MIDDLE NAME OF FATHER | 6B |
| MIDDLE NAME OF MOTHER | 9B |
| MONTH AND YEAR OF LAST TERMINATION | 27F |
| MONTH OF PREGNANCY OR DATE PRENATAL CARE BEGAN | 25B |
| MOTHER HISPANIC | 22 |
| MOTHER'S AGE AT CHILD'S BIRTH | MAGE |
| MOTHER'S COUNTY OF RESIDENCE | 24B |
| MOTHER'S CURRENT LAST NAME | MLN |
| MOTHER'S DATE OF BIRTH | 11 |
| MOTHER'S RACE | 21 |
| MOTHER'S RACE CODE | I21 |
| MOTHER'S RESIDENCE (STREET, NUMBER OR LOCATION) | 24A |
| MOTHER'S RESIDENCE CITY OR TOWN | 24C |
| MOTHER'S RESIDENCE ZIP CODE | 24E |
| MOTHER'S SOCIAL SECURITY NUMBER | 33 |
| MOTHER'S SPANISH CODE | I22 |
| MOTHER'S STATE OF BIRTH | 10 |
| MOTHER'S STATE OF RESIDENCE | 24D |
| MOTHER'S USUAL KIND OF BUSINESS OR INDUSTRY | 23B |
| MOTHER'S USUAL OCCUPATION | 23A |
| NAME AND TITLE OF CERTIFIER IF NOT ATTENDANT | 14 |
| NAME, TITLE AND MAILING ADDRESS OF ATTENDANT | 13D |
| NUMBER OF HIGHEST GRADE COMPLETED OR COLLEGE (13-17) FOR FATHER | 20C |
| NUMBER OF HIGHEST GRADE COMPLETED OR COLLEGE (13-17) FOR MOTHER | 23C |
| NUMBER OF LIVE BIRTHS NOW DEAD | 27B |
| NUMBER OF LIVE BIRTHS NOW LIVING (EXCLUDING THIS CHILD) | 27A |
| NUMBER OF MISCARRIAGES AFTER 20 WEEKS | 27E |
| NUMBER OF MISCARRIAGES BEFORE 20 WEEKS | 27D |
| NUMBER OF PRENATAL VISITS | 25C |
| PARENT OR OTHER INFORMANT - SIGNATURE (SURNAME ONLY) | 12A |
| PLACE OF BIRTH | 5A |
| PLACE OF BIRTH CODE | A |
| PLANNED PLACE OF BIRTH | 5E |
| PLANNED PLACE OF BIRTH CODE | E |
| PLURALITY CODE | I3A |
| PRINCIPAL SOURCE OF PAYMENT FOR DELIVERY | 28B |
| PRINCIPAL SOURCE OF PAYMENT FOR PRENATAL CARE | 25D |
| RESIDENCE CODE | B |
| RESIDENCE COUNTY CODE | I24B |
| SENT | SENT |
| SEX OF CHILD | 2 |
| SHARE SSA NUMBER WITH HEALTH DEPARTMENT? | SSA2 |
| SSA | F |
| STREET ADDRESS OR LOCATION | 5B |
| THIS BIRTH SINGLE, TWIN, ETC. | 3A |
| THIS CHILD 1ST, 2ND, ETC. | 3B |
Updated September 25, 1996 by RL Williams
