[regularfry]

In the absence of that sort of SSN, it has a higher impact than you'd think. It comes up enough in the UK to be something we have to plan around.

It's a particular problem in refugee communities, especially where there may be common names. No certificate, often. What happens is that the first time they need to know their birthdate is when they have interaction with a healthcare system, and the doctor (or the admin staff), when told "Oh, some time in 1931, I think", puts "1/1/1931" into the records.

All it takes is two of "Samuel Goldstein, born 1/1/1931" in the same suburb and you've got a serious risk of misidentification when one of them has a heart attack and turns up in an ambulance. Misidentification of patients might be relatively uncommon, but the danger when it happens is severe.