# Title 23 — Health and Safety

## Chapter 23-02.1 — Health Statistics Act

### § 23-02.1-01. Definitions.

As used in this chapter:
1. "Authorized representative" means a person that has the legal authority to act on
behalf of the person named on a record, including a personal representative or
guardian.
2. "Birth record" means a record reporting a live birth.
3. "Certified" means a copy of the original record on file with the department of health
and human services which is signed and sealed by the state registrar or deputy state
registrar.
4. "Dead body" means a lifeless human body or parts of such body or bones thereof from
the state of which it may reasonably be concluded that death recently occurred.
5. "Electronic birth registration system" means the electronic birth registration system
maintained by the department of health and human services.
6. "Electronic death registration system" means the electronic death registration system
maintained by the department of health and human services.
7. "Facts of death" means the demographic and personal information pertaining to an
individual's death.
8. "Fetal death" or "birth resulting in stillbirth" means death occurring before the complete
expulsion or extraction from its mother of a product of human conception. The death is
indicated by the fact that after such expulsion or extraction the fetus does not breathe
or show any evidence of life such as beating of the heart, pulsation of the umbilical
cord, or definite movement of voluntary muscles.
9. "Filing" means the presentation of a record, report, or other information provided for in
this chapter of a birth, death, fetal death, adoption, marriage, divorce, or other event as
specified by the department of health and human services for registration by the state
registrar.
10. "Final disposition" means the entombment, burial, interment, cremation, whole-body
donation to a school of medicine, removal from the state, or other disposition of a dead
body or fetus.
11. "Health statistics" means data derived from records of birth, death, fetal death,
marriage, divorce, or other records relating to the health of the populace or the state of
the environment.
12. "Homeless youth" means an individual under sixteen years of age living in one of the
situations described in 42 U.S.C. 11434(a)(2) and who is not in the care and physical
custody of a parent or legal guardian.
13. "Homeless youth agency" means an agency assisting a homeless youth in obtaining
the homeless youth's birth record.
14. "Institution" means any establishment, public or private, which provides inpatient
medical, surgical, or diagnostic care or treatment, or nursing, custodial, or domiciliary
care to two or more individuals unrelated by blood, or to which individuals are
committed by law.
15. "Live birth" means the complete expulsion or extraction from its mother of a product of
human conception, regardless of the duration of pregnancy, which after such expulsion
or extraction, breathes or shows any other evidence of life such as beating of the
heart, pulsation of the umbilical cord, or definite movement of voluntary muscles,
whether or not the umbilical cord has been cut or the placenta is attached.
16. "Medical certification" means the medical information pertaining to an individual's
death, including the cause and manner of death.
17. "Miscarriage of birth" means the expulsion of a fetus from the womb, spontaneously or
as a result of an accident, before twenty weeks gestation.
18. "Personal or real property interests" means ownership or other legal rights or duties
concerning personal or real property.

19. "Physician" means an individual authorized or licensed to practice medicine or
osteopathy under chapter 43-17.
20. "Registration" means the acceptance by the state registrar and incorporation into
official records, reports, or other records provided for in this chapter, of birth, death,
fetal death, marriage, divorce, or other records as may be determined by the
department of health and human services.
21. "Relative" means an individual's current or surviving spouse, a parent or legal
guardian, a child, a grandparent, or a grandchild. The state registrar may require proof
of the relationship.
22. "Sex" means the biological state of being female or male, based on the individual's
nonambiguous sex organs, chromosomes, or endogenous hormone profiles at birth.
23. "Subregistrar" means a funeral practitioner or other suitable individual from a licensed
funeral home who is appointed by the state registrar for the purpose of issuing final
disposition-transit permits.
24. "System of health statistics tabulation and analysis" includes the tabulation, analysis,
and presentation or publication of statistical data derived from health statistics.
25. "System of vital records registration" includes the registration, collection, preservation,
amendment, and certification of birth, death, fetal death, marriage, divorce, or other
records as may be determined necessary by the department of health and human
services.
### § 23-02.1-02. Office of statistical services.

There is hereby established in the department of health and human services an office of
statistical services, which shall install, maintain, and operate a system of health statistics
tabulation and analysis and a system of vital records registration throughout the state. The
commissioner of the department of health and human services or designee may create within
the office of statistical services such working divisions as may be necessary to comply with the
provisions of this chapter and shall appoint the directors of such divisions in accordance with the
merit system laws and regulations of the state of North Dakota.
### § 23-02.1-02.1. Birth, marriage, fetal death, and death records - Transition to electronic

birth registration system and electronic death registration system.
1. Beginning January 1, 2008, all new birth, fetal death, and death certificates must be
filed with the state registrar and maintained as birth, fetal death, or death records. The
state registrar shall issue certified copies of any birth, fetal death, or death record, or
informational copies of death and marriage records, to those persons entitled to the
record in accordance with this chapter.
2. A certified copy of a birth, marriage, fetal death, or death record is considered to meet
the requirements of any law requiring a birth, marriage, fetal death, or death certificate.
3. All birth, marriage, fetal death, and death certificates created or issued before
January 1, 2008, remain legally valid if the certificate was valid under prior law.
4. Any reference to a birth, marriage, fetal death, and death record includes any birth,
marriage, fetal death, and death certificate issued before January 1, 2008.
5. Amendments to birth records issued before 2006 and fetal death or death records
issued before 2008 must be made according to the procedures and processes used at
the time the original record was created.
### § 23-02.1-03. Director of the office of statistical services and associative duties, state

and deputy state registrars.
The commissioner of the department of health and human services or designee shall
appoint a director of the office of statistical services, in accordance with the merit system laws
and regulations of the state of North Dakota, who must be the ex officio state registrar of vital
statistics. The deputy state registrar of vital statistics must also be appointed by the
commissioner of the department of health and human services or designee. The director of the
office of statistical services shall administer and enforce this chapter and the rules and

regulations issued hereunder, and issue instructions for the efficient administration of a
statewide system of health statistics tabulation and analysis and a statewide system of vital
records registration. The director of the office of statistical services may delegate such functions
and duties vested in the director to the officers and employees of the office of statistical services
as the director deems necessary and expedient.
### § 23-02.1-04. Duties of the department.

The department of health and human services may adopt, amend, and repeal rules and
regulations for the purposes of carrying out the provisions of this chapter, in accordance with
chapter 28-32.
### § 23-02.1-05. Duties of the state registrar.

1. The state registrar shall:
a. Direct and supervise the statewide system of vital records and registration and be
the primary custodian of said records.
b. Direct, supervise, and control the activities of subregistrars and the activities of
other local officials related to the operation of the vital records registration
system.
c. Prescribe, with the approval of the department of health and human services, and
distribute such forms as required by this chapter and the rules and regulations
issued hereunder.
2. The deputy state registrar shall possess the powers of the state registrar during the
registrar's absence, delegation, inability to act, or during the time there is a vacancy in
the office.
### § 23-02.1-06. Registration districts.

Repealed by S.L. 2007, ch. 234, § 29.
### § 23-02.1-07. Duties of local registrars.

Repealed by S.L. 2007, ch. 234, § 29.
### § 23-02.1-08. Duties of subregistrars.

A subregistrar may issue final disposition-transit permits for those counties served by the
funeral home the subregistrar is employed by. The subregistrar or cemetery sexton shall file all
completed final disposition-transit permits with the county recorder in the county where the final
disposition took place within ten days after the date of final disposition or within the time
prescribed by the local board of health. The subregistrar is subject to the supervision and
control of the state registrar and may be removed by the state registrar for reasonable cause.
The subregistrar is subject to the penalties for neglect of duties as provided in section
23-02.1-32.
### § 23-02.1-09. Compensation of local registrars.

Repealed by S.L. 2007, ch. 234, § 29.
### § 23-02.1-10. Payment of fees to the local registrar.

Repealed by S.L. 2007, ch. 234, § 29.
### § 23-02.1-11. Form of records.

The form of the records, reports, and other information required by this chapter is subject to
the approval of and modification by the department of health and human services. In order to
maintain uniformity in the system of vital records registration and the system of health statistics
tabulation and analysis, substantial efforts should be made to ensure that information collected
parallels that collected by other primary registration areas.

### § 23-02.1-12. Date of registration.

Each record, report, and other information required to be filed under this chapter must have
entered upon its face the date of registration duly attested.
### § 23-02.1-13. Birth registration.

1. A birth record for each live birth that occurs in this state must be filed with the state
registrar.
2. If a birth occurs in an institution, the person in charge of the institution or a designated
representative shall use the department of health and human services' electronic birth
registration system to report the birth, including all personal and medical facts, to the
state registrar within five days after the birth.
3. If a birth occurs outside an institution, the required forms prescribed by the department
of health and human services must be prepared and filed with the state registrar,
within thirty days of the birth by one of the following in the indicated order of priority:
a. The physician in attendance at or immediately after the birth, or in the absence of
such an individual;
b. Any other individual in attendance at or immediately after the birth, or in the
absence of such an individual; or
c. The father, the mother, or in the absence of the father and the inability of the
mother, the individual in charge of the premises where the birth occurred.
4. If a man and the mother are or have been married or have attempted to marry each
other in apparent compliance with law, although the attempted marriage is or could be
declared invalid, and the child is born during the marriage or attempted marriage, or
within three hundred days after the termination of cohabitation or after the marriage or
attempted marriage is terminated by death, annulment, declaration of invalidity, or
divorce, or after a decree of separation is entered by a court, the name of the man
must be entered on the birth record as the father of the child unless the presumption of
paternity has been rebutted by a court decree.
5. If the child is not born during the marriage of the mother, or within three hundred days
after a marriage is terminated by death, annulment, declaration of invalidity, or divorce,
or after a decree of separation is entered by a court, the name of the father may not be
entered on the birth record unless:
a. After the child's birth, the father and the child's natural mother have married, or
attempted to marry, each other by a marriage solemnized in apparent compliance
with law, although the attempted marriage is or could be declared invalid, and:
(1) He has acknowledged his paternity of the child in writing filed with the state
registrar; or
(2) He is obligated to support the child under a written voluntary promise or by
court order;
b. After the child's birth, the child's natural mother and the father voluntarily
acknowledge the child's paternity on a form prescribed by the department of
health and human services, signed by the child's natural mother and biological
father, and filed with the state registrar; or
c. A court or other entity of competent jurisdiction has adjudicated paternity.
6. If, in accordance with subsections 4 and 5, the name of the father of the child is not
entered on the birth record, the child's surname must be shown on the birth record as
the current legal surname of the mother at the time of birth unless an affidavit or an
acknowledgment of paternity signed by both parents is filed with the department of
health and human services.
7. A birth record must include the designation of the sex of the child which must be either
male or female. An entry of "not yet determined" may not be entered unless the sex
cannot be determined based on the child's nonambiguous sex organs, chromosomes,
and endogenous hormone profiles at birth.

### § 23-02.1-14. Infants of unknown parentage - Foundling registration.

1. Whoever assumes custody of a living infant of unknown parentage shall report using
the electronic birth registration system or on a form and in the manner prescribed by
the state registrar within seven days to the state registrar the following information:
a. The date and place of finding.
b. Sex, color, or race, and approximate age of child and approximate date of birth.
c. Name and address of the persons or institution with whom the child has been
placed for care.
d. Name given to the child by the custodian.
e. Other data required by the state registrar.
2. The place where the child was found must be entered as the place of birth and the
date of birth must be determined by approximation.
3. A report registered under this section constitutes the birth record for the infant.
4. If the child is identified and a birth record is found or obtained, any report registered
under this section must be sealed and filed and may be opened only by order of a
court of competent jurisdiction or as provided by regulation.
### § 23-02.1-15. Delayed registration of birth.

1. If the birth of an individual born in this state has not been registered, a birth record
may be filed in accordance with the regulations of the department of health and human
services. The birth record must be registered subject to such evidentiary requirements
as the department of health and human services shall prescribe to substantiate the
alleged facts of birth.
2. A birth record registered one year or more after the date of occurrence must be
marked "delayed" and show on the face of the birth record the date of delayed
registration.
3. A summary statement of the evidence submitted in support of the delayed registration
must be endorsed on the birth record.
4. a. If an applicant does not submit the minimum documentation required in the
regulations for delayed registration or when the state registrar finds reason to
question the validity or adequacy of the birth record or documentary evidence, the
state registrar may not register the delayed birth record and shall advise the
applicant of the reasons for this action. If the deficiencies are not corrected, the
state registrar shall advise the applicant of the right of appeal to a court of
competent jurisdiction for a judicial determination of the birth facts.
b. The department of health and human services by regulation may provide for the
dismissal of an application that is more than one year old and is not being actively
pursued.
5. A report of live birth may not be registered for a deceased individual one year or more
after that individual's date of birth.
### § 23-02.1-16. Delayed registration of death.

When a death occurring in this state has not been registered within the time period specified
in section 23-02.1-19, a record may be filed in accordance with regulations of the department of
health and human services.
1. Such records must be registered subject to such evidentiary requirements as the
department of health and human services may by regulation prescribe to substantiate
the alleged facts of death.
2. Records of death registered one year or more after the date of occurrence must be
marked "delayed" and must show on their face the date of delayed registration.
### § 23-02.1-17. Court reports of adoption.

1. For each adoption decreed by any court in this state, the court shall require the
preparation of a report of adoption on a form prescribed and furnished by the state
registrar. The report must include such facts as are necessary to locate and identify

the birth record for the person adopted; provide information necessary to establish a
new birth record for the person adopted; and must identify the order of adoption and
be certified by the clerk of court.
2. Information in the possession of the petitioner necessary to prepare the adoption
report must be furnished with the petition for adoption by each petitioner for adoption
or petitioner's attorney. The department of health and human services or other persons
concerned shall supply the court with such additional information as may be necessary
to complete the report. The provision of such information is a prerequisite to the
issuance of a final decree.
3. Whenever an adoption decree is amended or annulled, the clerk of court shall prepare
a report thereof, which must include the facts necessary to identify the original
adoption report and the facts amended in the adoption decree as are necessary to
properly amend the birth record.
4. Not later than the fifth day of each calendar month, the clerk of court shall forward to
the state registrar reports of decrees of adoptions, annulment of adoption, or
amendments thereof entered in the preceding month, together with such related
reports as the state registrar shall require.
5. When the state registrar shall receive a report of adoption or annulment of adoption or
amendment thereof from a court for a person born in the United States but outside this
state, such report must be forwarded to the appropriate registration authority in the
state of birth.
### § 23-02.1-18. New birth records following adoption, legitimation, and paternity

determination.
1. The state registrar shall establish a new birth record for a person born in this state
when the registrar receives the following:
a. An adoption report as provided in section 23-02.1-17 or a certified copy of the
decree of adoption together with the information necessary to identify the original
birth record and to establish a new birth record; except that a new birth record
may not be established if so requested by the court decreeing the adoption, the
adoptive parents, or the adoptive person.
b. A request that a new record be established and such evidence as required by
rules and regulations proving that such person has been legitimated or that a
court of competent jurisdiction has determined the paternity of such person.
2. For a person born in a foreign country whose adoptive parents are residents of the
state of North Dakota at the time of the adoption, the state registrar shall prepare a
new birth record:
a. In the case of a foreign-born person adopted in North Dakota, upon presentation
of a report of adoption as required by section 23-02.1-17.
b. In the case of a foreign-born person adopted outside the state of North Dakota or
outside the United States, or in the state of North Dakota prior to July 1, 1979,
upon presentation of a certified copy of the adoption decree, and:
(1) A certified copy of the birth record of the adopted person; or
(2) An affidavit of an adoptive parent setting forth the true or probable date and
place of birth and parentage of the adopted person.
Any certification of a birth record issued under this subsection must be in the same
form as other certifications of birth records issued in this state except that it must state
that it does not purport to be evidence of United States citizenship.
3. When a new birth record is established, the actual place and date of birth must be
shown. The new birth record must be substituted for the original birth record:
a. Thereafter, the original birth record and the evidence of adoption, paternity, or
legitimation is not subject to inspection except upon order of a court of competent
jurisdiction or as provided by rules and regulations.
b. Upon receipt of a notice of annulment of adoption, the original birth record must
be restored to its place in the files and the new birth record and evidence is not
subject to inspection except upon order of a court of competent jurisdiction.

4. If no birth record is on file for the person for whom a new birth record is to be
established under this section, an original birth record must be filed with the state
registrar in accordance with the appropriate rules and regulations promulgated by the
department of health and human services. The new record is also to be prepared on
the standard forms in use at the time of the adoption, legitimation, or paternity
determination.
5. When a new birth record is established by the state registrar, all copies of the original
birth record in the custody of any custodian of permanent local records in the state
must be sealed from inspection or forwarded to the state registrar, as the registrar
directs.
### § 23-02.1-19. Death registration.

1. A death record for each death that occurs in this state must be filed with the state
registrar in accordance with the rules and regulations set forth by the department of
health and human services using the electronic death registration system. All
registration and issuing of copies of death records will be completed by the department
of health and human services.
2. The funeral director shall obtain the facts of death from the next of kin or the best
qualified individual or source available and must file the facts of death information
using the electronic death registration system within three days after assuming
custody of the dead body. The funeral director shall obtain the medical certification of
death from the individual responsible for the medical certification.
3. The medical certification must be completed and filed using the electronic death
registration system within ten days after death by the physician, physician assistant, or
nurse practitioner in charge of the patient's care for the illness or condition which
resulted in death except when inquiry is required by the local health officer or coroner.
4. When death occurred without medical attendance or when inquiry is required by the
local health officer or coroner, the county coroner shall investigate the cause of death,
and shall obtain medical information about the individual from the individual's medical
records or last-known physician or physician assistant, and shall complete and file the
medical certification within ten days after taking charge of the case using the electronic
death registration system.
5. If the cause of death cannot be determined within ten days after death, the medical
certification may be filed after the prescribed period, in accordance with rules adopted
by the department of health and human services. The attending physician, physician
assistant, nurse practitioner, or coroner shall give the funeral director in custody of the
body notice of the reason for the delay and final disposition may not be made until
authorized by the attending physician, physician assistant, nurse practitioner, or
coroner.
6. When a death is presumed to have occurred within this state but the body cannot be
located, a death record may be prepared by the state registrar upon receipt of findings
of a court of competent jurisdiction, including the facts of death and medical
certification required to complete the death record. The death record must be marked
"presumptive" and must show on the face of the death record the date of registration
and must identify the court and the date of the decree.
7. Each death registration must include the social security number of the decedent, if the
information is available. A social security number included on a death record is
confidential and may be disclosed only to a relative or authorized representative of the
individual named on the record, to a person with personal or real property interests
that depend upon information contained in the death record, or by an order of a court
of competent jurisdiction.
### § 23-02.1-20. Fetal death registration.

1. A fetal death record for each fetal death that occurs in this state after a gestation
period of twenty completed weeks or more must be filed with the state registrar.

2. When a fetal death occurs in an institution, the person in charge of the institution or a
designated representative shall use the department of health and human services'
electronic fetal death registration system to report the fetal death, including all
personal and medical facts, to the state registrar within ten days after the delivery. If a
fetal death occurs outside of an institution, a funeral director or other individual in
attendance at or after delivery shall file the fetal death record.
3. When inquiry is required by the local health officer or coroner or in the absence of
medical attendance, the county coroner shall investigate the cause of fetal death, and
shall obtain medical information about the individual from that individual's medical
records or last-known physician or physician assistant and file the medical certification
within ten days after taking charge of the case using the electronic death registration
system.
4. If the cause of fetal death cannot be determined within ten days after death, the
medical certification may be filed after the prescribed period of time in accordance with
rules adopted by the department of health and human services. The attending
physician, physician assistant, nurse practitioner, or coroner shall give the funeral
director in custody of the fetus the notice of the reason for the delay and final
disposition may not be made until authorized by the attending physician, physician
assistant, nurse practitioner, or coroner.
5. The provision for entering the name of the father of the fetus on the fetal death record
and the reporting of out-of-wedlock fetal deaths concur exactly with those set forth in
section 23-02.1-13.
### § 23-02.1-20.1. Fetal loss.

The state registrar may issue a certified copy of a fetal loss to an individual who
experiences a documented miscarriage of birth, if the individual provides to the state registrar a
completed fetal loss request form established by the department of health and human services
which is signed by the mother or the father and a letter signed by a hospital, physician, or other
medical attendant documenting proof of pregnancy and fetal loss.
### § 23-02.1-21. Permits.

1. The funeral practitioner who first obtains custody of a dead body or fetus shall obtain a
final disposition-transit permit before final disposition or removal from this state of the
body or fetus.
2. The final disposition-transit permits must be issued by the state registrar or a
subregistrar and must be filed in the office of the county recorder where the final
disposition occurs in accordance with the requirements of sections 23-02.1-19 and
23-02.1-20.
3. A final disposition-transit permit issued under the laws of another state which
accompanies a dead body or fetus brought into this state is authority for final
disposition of the body or fetus in this state.
4. A permit for disinterment and reinterment is required before disinterment of a dead
body or fetus except as authorized by rules or otherwise provided by law. The permit
must be issued by the state registrar to a funeral practitioner upon proper application.
### § 23-02.1-22. Extension of time.

1. The department of health and human services may, by regulation and upon such
conditions as it may prescribe to assure compliance with the purposes of this chapter,
provide for the extension of the periods of time prescribed in sections 23-02.1-19,
23-02.1-20, and 23-02.1-21 for the filing of death records, fetal death records, medical
certification of death, and for the obtaining of final disposition-transit permits in cases
in which compliance with the applicable prescribed period would result in undue
hardship.
2. Regulations of the department of health and human services may provide for the
issuance of a final disposition-transit permit under section 23-02.1-21 before the filing

of a record of death or fetal death upon conditions designed to assure compliance with
the purposes of this chapter in cases in which compliance with the requirement that
the records be filed before the issuance of the permit would result in undue hardship.
### § 23-02.1-23. Marriage registration.

1. A record of each marriage performed in this state must be filed with the state registrar
as provided in this section.
2. The officer who issues the marriage license shall prepare the record on the form
prescribed and furnished by the state registrar upon the basis of information obtained
from the parties to be married, who shall attest to information by their signatures.
3. Every person who performs a marriage shall certify the fact of marriage and file the
record with the officer who issued the license within seven days after the ceremony.
4. Every officer issuing a marriage license shall complete and forward to the state
registrar, on or before the fifth day of each calendar month, a copy of the marriage
records specified in subsection 1 for marriages filed with that officer during the
preceding calendar month.
### § 23-02.1-24. Court reports of divorce and annulment of marriage.

1. For each divorce and annulment of marriage granted by any court in this state, a
report must be prepared and filed by the clerk of court with the state registrar. The
information necessary to prepare the report must be furnished, with the petition, to the
clerk of court by the parties or their legal representatives on forms prescribed and
furnished by the state registrar.
2. On or before the fifth day of each month, the clerk of court shall forward to the state
registrar the report of each divorce and annulment granted during the preceding
calendar month and such related reports as may be required by regulations issued
under this chapter.
### § 23-02.1-25. Correction and amendment of vital records.

1. A record registered under this chapter may be amended only in accordance with this
chapter and regulations under this chapter adopted by the department of health and
human services to protect the integrity and accuracy of vital records.
2. A record that is amended under this section must be marked "amended" except as
provided in subsection 4. The date of amendment and a summary description of the
evidence submitted in support of the amendment must be endorsed on or made a part
of the record. The department of health and human services shall prescribe by
regulation the conditions under which additions or minor corrections may be made to
birth records within one year after the date of birth without the record being considered
as amended.
3. Upon receipt of a certified copy of a court order that is amending a birth, death, or fetal
death record and upon request of such individual or the individual's parent, guardian,
or legal representative, the state registrar shall amend the record as directed in the
court order; however, if the state registrar has information to believe the facts of the
court order are false or inaccurate, the state registrar shall provide the court and any
known parties with the correct information.
4. Upon receipt of a sworn acknowledgment of paternity of a child born out of wedlock
signed by both parents and upon request, the state registrar shall amend a record of
birth to show such paternity if paternity is not shown on the record. Upon request of
the parents, the surname of the child must be changed on the appropriate record to
the surname designated by the parents on the acknowledgment of paternity. Such
record may not be marked as "amended". The provisions of this subsection apply also
in their entirety to records of fetal death.

### § 23-02.1-25.1. Birth records - Amendments and corrections - Sex change.

1. The sex designation on a birth record of an individual born in this state may not be
amended under section 23-02.1-25 due to a gender identity change.
2. The sex designation on a birth record of an individual born in this state may not be
amended or corrected under section 23-02.1-25 unless:
a. The sex of the individual was listed incorrectly on the original birth record as a
result of a scrivener's error or data entry error;
b. The sex of the individual was misidentified on the original birth record and the
request for correction is accompanied by a copy of the results of chromosomal,
molecular, karyotypic, DNA, or genetic testing that identifies the sex of the
individual, together with an affidavit from the health care facility, health care
professional, or laboratory testing facility that conducted the test or analyzed the
test results, attesting to the test results and the accuracy of the test results; or
c. The sex of the individual was changed with anatomically correct genitalia for the
identified sex as certified by a medical provider.
3. As used in this chapter, "sex" means the biological state of being male or female,
based on an individual's nonambiguous sex organs, chromosomes, or endogenous
hormone profiles at birth.
### § 23-02.1-26. Reproduction of records.

To preserve original documents, the state registrar is authorized to prepare typewritten,
photographic, electronic, or other reproductions of original records and files in the state
registrar's office. These reproductions when certified by the state registrar must be accepted as
the original record.
### § 23-02.1-27. Disclosure of records.

Birth, death, and fetal death records, filings, data, or other information related to birth,
death, and fetal death records are confidential and may not be disclosed except as authorized
under this chapter. The state registrar shall restrict access to all vital records to protect vital
records from loss, mutilation, or destruction and to prevent disclosure of the information
contained in these records except as authorized under this chapter.
1. A certified copy of a birth record may be issued to the individual named on the record if
that individual is at least sixteen years old, to a parent named on the record, to an
authorized representative, to a homeless youth agency, or by the order of a court of
competent jurisdiction. If the individual named on a birth record is deceased, a certified
copy of that record may also be issued to a relative. If the date of birth on any birth
record is more than one hundred and twenty-five years old, that record is an open
record and a certified copy may be issued to anyone, except that adoption records
remain confidential.
2. A certified copy of a complete death record may be issued to a relative, an authorized
representative, the child fatality review board, a licensed physician, or a genetic sibling
for the purposes of researching family medical history; a funeral director, coroner,
medical examiner, or state forensic examiner reporting the facts of death; the
commissioner of veterans' affairs for a death record of an individual designated as
having served in the United States armed forces; a person with personal or real
property interests that depend upon information contained in the complete death
record; or by the order of a court of competent jurisdiction, and may include the cause
of death and the social security number. A certified copy of the facts of death record
that includes the facts of death and the social security number may be issued to any
person that may obtain a certified copy of a complete death record or to any licensed
attorney who requires the copy for a bona fide legal determination. A certified copy of
an informational death record may be issued to the general public, but the copy may
not contain the cause of death or the social security number.
3. A certified copy of a fetal death record may be issued to a parent named on the record,
an authorized representative, or by the order of a court of competent jurisdiction. A

person authorized to receive a certified copy of a fetal death record may request the
certified copy be issued in the form of a certification of birth resulting in stillbirth.
4. A noncertified informational copy of a marriage record may be issued to the general
public.
5. A person authorized to receive a certified copy of any specific record may grant
another person the same authority by completing a written authorization on a form
prescribed by the state department of health.
6. The department of health and human services may grant limited access to birth and
death information to divisions and programs of the department of health and human
services, the department of transportation, the protection and advocacy project, and
the information technology department necessary for the purpose of completing their
respective official duties.
7. The department of health and human services may issue, through electronic means
determined by the department of health and human services, verifications of
information contained on birth or death records filed with the state registrar when such
information is provided and a verification is requested by a governmental agency,
whether foreign or domestic, in the conduct of the agency's official duties. The
department of health and human services may also issue these electronic verifications
for a negotiated and agreed-upon fee to:
a. Benefit-paying parties, such as annuity companies, pension plans, and life
insurance companies, that demonstrate a need for such information to determine
whether the benefits the benefit-paying party are paying should be terminated or
distributed to a beneficiary;
b. Physicians licensed to practice in the United States who demonstrate such
information is needed to determine whether a patient the physician is treating has
been lost to care;
c. Attorneys licensed to practice in the United States who demonstrate that the
information is necessary to administer the attorneys' client's estate; or
d. Other entities for fraud prevention as determined by the state registrar.
### § 23-02.1-28. Copies of data from vital records.

In accordance with section 23-02.1-27 and the regulations adopted pursuant thereto:
1. The state registrar shall, upon request of a person entitled to a copy under section
23-02.1-27, issue a certified copy of any record or part of a record in the registrar's
custody. Each copy issued must show the date of registration; and copies issued from
records marked "delayed", "amended", or "court order" must be similarly marked and
show the effective date of filing.
2. A certified copy of a record or any part of the record issued in accordance with
subsection 1 must be considered evidence of the facts stated in the record, provided
that the evidentiary value of a record filed more than one year after the event, or a
record which has been amended, must be determined by the judicial or administrative
body or official before whom the record is offered as evidence.
3. Data or copies may be furnished for statistical purposes to federal, state, local, or
other public or private agencies, including the federal agency responsible for national
vital statistics, upon such terms and conditions as may be prescribed by the
department of health and human services through rules and regulations adopted
pursuant to this chapter.
4. No person may prepare or issue any certificate or record which purports to be an
original, certified copy, or copy of a certificate or record of birth, death, or fetal death,
except as provided in this chapter, or regulations adopted under this chapter.
5. A certified copy may not disclose an individual's social security number unless the
copy is being provided to the individual to whom it pertains, a relative or authorized
representative, or by order of a court of competent jurisdiction.

### § 23-02.1-29. Fees.

1. The department of health and human services shall prescribe the fees, if any, not to
exceed fifteen dollars, to be paid for the following:
a. Each certified copy of a record.
b. Each certified statement of the facts of birth other than a copy of the original birth
record.
c. Each filing of a new record of birth or fetal death following adoption.
d. Each filing of a delayed record of birth or death except as provided for in
subsection 4 of section 23-02.1-18.
e. Each filing of an amendment to a birth or death record.
f. A search of the files or records when no copy is made.
g. A noncertified informational copy of a death or marriage record.
The fee for each additional copy of a death or fetal death record, requested at the
same time, may not exceed ten dollars.
2. Except as otherwise provided in subsection 3, fees collected under this section by the
state registrar must be deposited in the operating fund of the department of health and
human services, according to procedures established by the state treasurer.
3. The department of health and human services shall quarterly pay fees in the amount
of two dollars for the issuance of each certified copy of a birth record, authorized by
subsection 1, into the children's trust fund created by section 50-27-01.
4. All fees collected in excess of the fees appropriated must be transferred to the general
fund of this state at the end of each biennium.
### § 23-02.1-30. Persons required to keep records.

1. Every person in charge of an institution as defined in this chapter shall keep a record
of personal particulars and data concerning each person admitted or confined to such
institution. This record must include all information required by the standard record of
birth, death, and fetal death forms issued under the provisions of this chapter. The
record must be made at the time of admission from information provided by such
person, but when it cannot be obtained from that person, the information must be
obtained from relatives or other persons acquainted with the facts. The name and
address of the person providing the information must be a part of the record.
2. When a dead body or fetus is released or disposed of by an institution, the person in
charge of the institution shall keep a record showing the name of the deceased, date
of death, name and address of the person to whom the body is released, date of
removal from the institution, or if finally disposed of by the institution, the date, place,
and manner of disposition must be recorded.
3. A funeral director, embalmer, or other person who removed from the place of death or
transports or finally disposes of a dead body or fetus, in addition to filing any record or
other form required by this chapter, shall keep a record which must identify the body,
and the information pertaining to receipt, removal, and delivery of the body as may be
prescribed in regulations adopted by the department of health and human services.
4. Records maintained under this section must be made available to the state registrar or
the registrar's representative for inspection upon demand.
5. On or before the fifth day of each month, each hospital, institution, funeral director,
embalmer, or person acting as such in this state shall report to the state registrar, on
forms provided for this purpose, information required by the state registrar regarding
each birth, death, or fetal death handled during the preceding calendar month.
### § 23-02.1-31. Duties to furnish information relative to vital events.

Any person having knowledge of the facts shall furnish such information as the person may
possess regarding any birth, death, fetal death, marriage, or divorce upon demand of the state
registrar.

### § 23-02.1-32. Penalties.

1. a. Any person who willfully and knowingly makes any false statement in a report,
record, or certificate required to be filed under this chapter, or in application for an
amendment thereof, or who willfully and knowingly supplies false information
intending that such information be used in the preparation of any such report,
record, or certificate, or amendment thereof;
b. Any person who, without lawful authority and with the intent to deceive, makes,
alters, or mutilates any report, record, or certificate required to be filed under this
chapter or a certified copy of a report, record, or certificate;
c. Any person who willfully and knowingly uses or attempts to use or to furnish to
another for use, for any purpose of deception, any certificate, record, report, or
certified copy thereof so made, altered, amended, or mutilated;
d. Any person who, with the intention to deceive, willfully uses or attempts to use
any certificate of birth or certified copy of a record of birth knowing that such
certificate or certified copy was issued upon a record which is false in whole or in
part or which relates to the birth of another person;
e. Any person who willfully and knowingly furnishes a certificate of birth or certified
copy of a record of birth with the intention that it be used by a person other than
the person to whom the record of birth relates; or
f. Any person who knowingly prepares, delivers, or uses a fraudulent or forged copy
of a vital record;
is guilty of a class C felony.
2. a. Any person who refuses to provide information required by this chapter;
b. Any person who knowingly transports or accepts for transportation, interment, or
other final disposition of a dead body or fetus without an accompanying final
disposition-transit permit as provided in this chapter; or
c. Any person who willfully neglects or violates any of the provisions of this chapter
or refuses to perform any of the duties imposed upon the person by this chapter;
is guilty of an infraction.
### § 23-02.1-33. Short title.

This chapter may be cited as the "Health Statistics Act".
