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| Entity No: "2471"
Record Series of Utah Government
| 18 results |
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These death certificates document all deaths occurring in the State of Utah as required by UCA 26-2-13 (1995). In 1905, a state registry system of vital statistics was established at the State Health Department with local registrars. All certificates created before 1905 ...
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Series: 11068
Creator Information Other Records Produced by This Entity Total Retention: Retain permanently |
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This is a monthly report on special fees collected by the local registrar from the purchase of birth and death certificates. A $3 fee is collected for the Child Trust Fund when a person purchases the first certificate copy of a birth certificate. This fund is used for ...
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Series: 10732
Creator Information Other Records Produced by This Entity Total Retention: Retain for 4 year(s) |
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These county forms report weekly and monthly statistics for diagnosed cases of each communicable disease in Davis County for a five year period. It is used locally for program planning purposes. The reports include communicable disease name, number of reported cases per ...
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Series: 10718
Creator Information Other Records Produced by This Entity Total Retention: Permanent. Retain for 1 year(s) |
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These statements are used to bill mortuaries for receiving certified death certificates. Mortuaries purchase multiple copies of certified death certificates at a discount rate and provide copies to the deceased's family. They include the month of service, mortuary's ...
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Series: 10733
Creator Information Other Records Produced by This Entity Total Retention: Retain for 4 year(s) |
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Billings sent to businesses to collect fees for various issued permits, sent annually or biannually. They include date, business name and address, date payment due, account number, services provided and amount due, total amount due, date and amount paid and receipt ...
Topics: Invoices--Utah--Davis County. |
Series: 12091
Creator Information Other Records Produced by This Entity Total Retention: Retain for 5 year(s) after final action |
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This state form is used by the father to acknowledge the paternity of a child when he is not married to the child's mother. The original form is retained by the State Health Department permanently. The form includes child's name, birth date and place, mother's name and ...
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Series: 10729
Creator Information Other Records Produced by This Entity Total Retention: Permanent. Retain for 1 year(s) |
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These cards serve as an index to birth and death certificates. The birth card includes name, certificate number, parents' names, child's name, and birth date. The death card includes name, death certificate number, death date, and birth date.
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Series: 10716
Creator Information Other Records Produced by This Entity Total Retention: Permanent. Retain until superseded |
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These monthly report forms document the use of personal vehicles for business by public health nurses. They are used to receive reimbursements for the usage. They include two forms-the Davis County mileage record and the expense voucher for mileage reimbursement. The ...
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Series: 10951
Creator Information Other Records Produced by This Entity Total Retention: Retain for 3 year(s) |
Davis County (Utah). Health Department. Administration Division Board member application , 1980-2000
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This is an application used to apply for a position on the local board of health. All applications are retained for two years to create a pool for possible future openings. The form includes name, address, business and home telephone numbers, education and work ...
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Series: 11066
Creator Information Other Records Produced by This Entity Total Retention: Retain for 2 year(s) |
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This worksheet is used to bill insurance companies. It includes date of service, patient information (name, address, telephone number, sex, date of birth, sex, and social security number); insurance information (insurance company name, subscriber's name, policy number, ...
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Series: 18963
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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This application is used by a veteran's next of kin to obtain a death certificate. One free certificate is available to veteran's next of kin for submission as evidence to the Veteran's Administration to receive a burial allowance and other veterans benefits. The ...
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Series: 11072
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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This three-part report form is submitted by nursing homes reporting deaths that occurred during the previous month. This report is required by UCA 26-2-23(3) (1995). It is used to determine whether certificates have been received for all deaths and to create state ...
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Series: 10721
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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This application form is used to request a certified birth certificate or birth card. It includes the name, date of birth, and city of birth of the individual whose birth certificate is being requested; the applicant's name, address, telephone number, and relationship ...
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Series: 10646
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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This three-part form is submitted monthly by all hospitals reporting all deaths, fetal deaths, or abortions that occurred during the month. It is required by UCA 26-2-23(3) (1995) and is used to ensure that all death certificates are filed. The original is maintained by ...
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Series: 10720
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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This application is used to request a certified death certificate. It includes identifying information, death date, deceased's name, place of death, county birthplace of decedent, usual residence of decedent, name of father, mother, reason for requesting including ...
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Series: 10717
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) after expiration of permit or license |
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County health departments use voluntary declaration of paternity/father information forms to add father information to birth certificate applications completed by mothers who were not married at the time of giving birth. The completed form is attached to the birth ...
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Series: 25913
Related Records (1) Creator Information Other Records Produced by This Entity Total Retention: Retain until final action |
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This three-part report form lists all interments and is prepared monthly by all cemeteries in the state and submitted to their local health department as required by UCA 26-2-18(3) (1995). The information is used by the department to verify that all death certificates ...
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Series: 10723
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
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These minutes document the actions of the local boards of health. Each local health department is required to have a board of health "appointed by the local governing body and shall consist of at least five persons" (UCA 26A-1-109 (1995)). The Board of Health is ...
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Series: 10715
Creator Information Other Records Produced by This Entity Total Retention: Retain permanently |