19. Certifier’s name and title

• M.D. (doctor of medicine)
• D.O. (doctor of osteopathy)
• Hospital administrator or designee
• CNM/CM (certified nurse midwife or certified midwife, includes APRN)
• Other midwife (midwife other than CNM/CM, includes CPM)
• Other (specify)

Enter the name and title of the individual who certified to the fact that the birth occurred.

The individual may be, but need not be, the same as the attendant at birth.