AGENCY: Davis County (Utah). Health Department. Administration Division

SERIES: 11071
TITLE: Monthly hospital birth report
DATES: undated.
ARRANGEMENT: None

DESCRIPTION: This three-part form is submitted by hospitals reporting live births that occurred during the month. It is used to ensure that all birth certificates were received as required by UCA 26-2-5_ (1995). The original is maintained by the local health department while the first copy is submitted to the State Health Department and the second copy is retained by the reporting hospital. The form includes the month of the report, hospital's name, and a list of births giving the date of birth, the parent's names, the child's sex, and the name of the medical attendant.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series is proposed and has not yet been approved.

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then destroy.

APPRAISAL

PRIMARY DESIGNATION

Public

---