Kate Middleton new title
Catherine, Duchess of Cambridge, would get a new title should Prince Charles become king. Catherine is picture with husband Prince William, son Prince George and daughter Princess Charlotte in Bucklebury, Berkshire, on Dec. 25, 2016. Getty Images

Kate Middleton rings in her 35th birthday on Monday and this year could very well be the last the Duchess of Cambridge celebrates with her title. With Queen Elizabeth II’s health being called into question, Catherine could welcome in her 36th year with a new royal moniker.

Queen Elizabeth’s son, Prince Charles, is next in line to the British throne, followed by his eldest son, Prince William, Duke of Cambridge. With Charles acting as king, William would be known as Prince of Wales and his new position would mean his wife, Catherine, would be known as HRH The Duchess of Cornwall (a title currently held by Prince Charles’s wife, Camilla) and Cambridge. Royal Central notes she may decide to go by just one of these titles.

If Prince William were to lead, should Charles pass or abdicate the throne to him, Kate would only be given a ceremonial queen title, despite her marital status, and would be known as a royal consort.

After William, the throne would go to the couple’s 3-year-old son Prince George, as Kate has no claim to the royal throne. William and Kate’s 1-year-old daughter Princess Charlotte is fourth in line and if she were to lead, she would become queen. William’s brother Prince Harry falls fifth in line.

The buzz surrounding the Queen Elizabeth’s health started in December when she and husband Prince Philip announced they would be canceling their annual Christmas trip. As reporters lineup to watch the couple make their way to Sandringham, England, they were informed the duo was suffering from “heavy colds.”

Though Princess Anne said her mother was feeling “better” after she missed New Year’s church service in Sandringham earlier this month, the 90-year-old has been slowly passing off her royal duties. Queen Elizabeth recently announced she was stepping down as royal patron from 25 charities, a small number of which she will hand off to other royal family members. Queen Elizabeth was last seen attending a service at St. Mary Magdalene Church in Sandringham, Norfolk, on Sunday.