database Not Connected Civil Registration System

Birth Reporting X

From

To

Death Reporting X

From

To

 
 
 
 
 
         
       
 
सं. 1
No. 1
 
  प्रपत्र-6
Form-6
  
 
 
   
 
 
 
   
       
   
DEATH CERTIFICATE 		   
         
         
 
 
         
         
 
 
         
         
 
/ Name: / Sex:
/ Date of Death:

/ Place of death:
/ AGE OF DECEASED :
/ NAME OF HUSBAND / WIFE :
 
  		/ HUSBAND / WIFE AADHAAR NO:
 
/ Name of Mother:
/ Name of Father :
/ MOTHER'S AADHAR:
  		/ FATHER'S AADHAR
 
/ ADDRESS OF DECEASED AT THE TIME OF DEATH:

/ PERMANENT ADDRESS OF DECEASED:

/ Registration Number:
 / Date of Registration:
/ Remarks (if any):
---

/ Date of issue:
/ Issuing Authority :



Updated on :
 
   
 
"This is a computer generated certificate which contains facsimile signature of the Issuing Authority"
" The Govt. of India vide circular No. 1/12/2014-VS(CRS) dated 27-July-2015 has
approved this certificate as a valid legal document for all official purposes".
" " / "Ensure registration of every birth and death" 		 
         
       
         
 
 
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