SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
Dear: -Justice Committee Division of Trieu Phong District.
-People’s Committee of Trieu Phuoc Commune.
-Commune Clinic and Midwife.
-Head of Village.
Application for Report of Birth
Full name : NGUYEN THI LAN HUONG.
Date of birth : May 17th ,1979.
Native place :Nhu Ly – Trieu Phuoc – Trieu Phong – Quang Tri.
Father ‘s name: Nguyen Viet Hanh,born in:1946.
Mother’s name : Le Thi Dinh,born in :1949.
Our children was born at Trieu Phuoc commune clinic,midwife:Nguyen Thi Bay at Commune Clinic.
So I wrote this application hope the levels confirm for my family.