Certificate for the declaration of the death of a child under one year or stillborn

The form for the declaration of the death of a child under one year or stillborn must be completed for any child that dies within its first year or for a stillbirth whose birth weight is at least 500g or whose gestational age is at least 22 weeks or whose length at birth from head to toe is at least 25 cm (WHO criteria). The form is divided into four sections. Section A, not anonymous, is to be completed by the doctor and retained by the Municipal administration. Section B is to be filled in by the doctor and will be checked by the Municipal administration before being sent off with the rest of the form to the Regional Medical Officer at the regional administration health. Section C, which contains the medical information, is to be filled in and placed in a sealed envelope by the doctor (this information cannot be accessed by the Municipal administration). It will be opened for the the regional administration health by the doctor in charge. Section D, which contains anonymous administrative and social information, is to be completed by the Municipal administration. The forms are printed by the Directorate-General for Statistics and Economic Information, which is responsible for supplying them to Local Authorities and to maternity wards. Municipal administrations are in charge of distributing the forms to doctors and hospitals within their municipality.