MEDICAL CERTIFICATE OF BIRTH

Neonatal Name: XXXXXX             Gender: Female       Time of Birth: XXXXXX

Gestational Age: 41 Week            Birth Weight: 3475g            Birth Length: 50 cm

Birth Place: XXXXXX Jilin Province Medical Institutions: Changchun Obstetrics and Gynecology Hospital

Mother's Name: XXXXXX Age: 27 Nationality: P.R. China              Ethnicity: Han      Address: No. XXXXXX

Valid Identification: Identity Card √   Passport □   Others  / Valid Identification No.: XXXXXX

Father's Name: XXXXXX Age: 32 Nationality: P.R. China               Ethnicity: Han      Address: XXXXXX Jilin Province

Valid Identification: Identity Card √   Passport □   Others  / Valid Identification No.: XXXXXX

Issued Authority (Stamp): XXXXXX

Date Issued: September 22, 2015

Seal: Seal Specific for Birth Medical Certificate, Jilin

XXXXXX Changchun City

No. P XXXXXX

第一页，律师宣誓页

第二页出生证翻译页

第三页出生证中文页

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