North Dakota Fetal Death Record Copy Request (SFN 61643)
Official state formStillbirth and pregnancy lossForm SFN 61643Free downloadLast verified November 10, 2026
Request for a certified copy of a North Dakota fetal death record. A Birth Resulting in Stillbirth copy is available on request. Sent by mail to Vital Records.
Who can use this form
- A parent named on the record
- An authorized representative (include the court order)
- A court-ordered copy (include the court order)
What to send with it
- The completed form
- One primary ID, or two secondary IDs, or a notarized application (see the form's instructions)
- A check or money order payable to ND DHHS
Where to send it
- Mail to
- Vital Records 600 E. Boulevard Ave., Dept. 325 Bismarck, ND 58505-0250
- State fee
- $15 for the first copy and $10 for each additional copy
- Typical processing
- 3-5 business days after receipt, plus mail time
- Form revision
- 10-2025
- Source
- Official government page