Meeseva GHMC Application for Death Certificate

Meeseva GHMC Application for Death Certificate

Download Meeseva GHMC Application for Death Certificate

APPLICATION FOR DEATH CERTIFICATE
CIRCLE / LOCALITY:
1. Date of Death:
2. Name of the Deceased:
3. Sex of the Deceased:
4. Name of the Father of the deceased:
5. Name of the Mother:
6. Place of Death:
(Tick the appropriate entry a, b, c below and give the name of the Hospital/Institute or the Address of the House where the Death took place.If other place gives location)
a) Hospital/Institution Name:
b) House Address:
c) Other place:
7. No. of Copies Required:
8 a) Do you
want the Death Certificate by Courier
b) If Yes give Name and Address with Pin Code
Name & address.
Note: -
Death certificate will be issued subject to entry found Registered with records.