Form Dhcs 0004 - California Request For California Birth Record (Hmong) - Health And Human Services Agency

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State of California – Health and Human Services Agency
Department of Health Care Services
Daim Ntawv Thov Ntawv Yug hauv Kalifonias
Medi-Cal yuav nrhiav tau cov ntawv yug rau cov tibneeg uas yug hauv Kalifonias — tsis yog nrhiav tau dawb!
Hnub no yog hnubtim:
Hlis:
Hnub:
Xyoo:
Cov kev qhia:
• Ua daim ntawv no. Ntaus
Tus neeg uas ua daim ntawv no:
Npe:
Npe nrab:
Xeem:
lossis sau tej tus tsiaj
ntawv. Koj siv tau tej kev
Koj xav tau leejtwg daim ntawv yug?
qhia hauv daim copy
Lub npe hauv daim ntawv yug:
ntawm daim ntawv yug los
Npe:
Npe nrab:
Xeem:
ua daim ntawv no.
Yog tus neeg no raug lwm tus yuav
• Nqa lossis xa daim
coj mus tu, sau lub npe/xeem tshiab:
Npe:
Npe nrab:
Xeem:
ntawv ua tas lawm no
mus rau lub chaw
Yog:
Tub
Ntxhais
pabcuam pejxeem hauv
koj lub nroog.
Hnub yug:
Hlis:
Hnub:
Xyoo:
• Yog koj ua tsis tau daim
Lub Nroog thiab County uas yug:
ntawv no, hu mus rau lub
Nroog :
County hauv Kalifonias:
chaw pabcuam pejxeem
Leej niam lub npe:
Npe:
Npe nrab:
Xeem:
hauv koj lub nroog.
Tej zaum peb yuav nrhiav
Leej txiv lub npe:
Npe:
Npe nrab:
Xeem:
tsis tau daim ntawv yug uas
koj xav tau. Yog muaj li no,
Tus Lej Daim Ntawv Yug #
(yog paub):
koj yuav tau muab lwm yam
puavpheej uas qhia tau tias
yog neeg Amelikas.
Tus ntxiv uas koj xav tau
daim ntawv yug:
Npe:
Npe nrab:
Xeem:
Yog peb nrhiav tau daim
ntawv yug lawm, los koj
Yog tus neeg no raug lwm tus yuav
yuav tau muab tej
coj mus tu, sau lub npe/xeem tshiab:
Npe:
Npe nrab:
Xeem:
puavpheej uas qhia tias yog
leejtwg tiag.
Yog:
Tub
ntxhias
Lub
county
lub chaw pabcuam
pejxeem xav tau cov kev qhia no
Hnub yug:
Hlis:
Hnub:
Xyoo:
los nrhiav daim ntawv yug hauv
Kalifonias los qhia tias yog neeg
Lub Nroog thiab County uas yug:
Nroog:
County hauv Kalifonias:
Amelikas tiag. Koj tsis muab cov
kev qhia no los tau.Tabsis yog koj
Leej niam lub npe:
Npe:
Npe nrab:
Xeem:
tsis muab, tej zaum lub
county
yuav tsis muaj peevxwm nrhiav
Leej txiv lub npe:
Npe:
Npe nrab:
Xeem:
tau koj daim ntawv yug.
Tus Lej Daim Ntawv Yug #
(yog paub):
Yog koj xav tau ntau tshaj li ob daim ntawv yug, ua ib daim ntawv thov ntxiv.
DHCS 0004 (06/07) – Hmong
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