GOVERNMENT OF MADHYA PRADESH

MuT-6
FORM-6

DEPARTMENT OF PLANNING, ECONOMICS & STATISTICS

MUNICIPAL cORPORATION SATNA

THTUT-Y7
DEATH CERTIFICATE

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE MADHIYA PRADESH REGISTRATION
OF BIRTHS & DEATHS RULES 1999.)

THIS IS TO CERTIFY THAT THE POLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER POR
MUNICIPAL CORPORATION SATNA OF TAHSIL/BLOCK RAGHURAJNAGAR OF DISTRICT SATNA OF STATE/UNION TERRITORY MADHYA PRADESH, INDIA.

T I NAME OF DECEASED: PUSHPA GUPTA TeAT /SEX:H16T/FEMALE

3TETT T AADHAAR NO:
XXXXKx3360

fa/DATE OFDEATH: T 7 /PLACE OF DEATH:

24-08-2021 SWAMI JI CHAURAHA, MUKHTYARGANJ, SATNA,
TWENTY-FOURTH-AUGUST-THO THOUSAND TWENTY ONE RAGHURAJNAGAR, SATNA, MADHYA PRADESH.

H T 3 IAGE OF DECEASED:
T 74NAME OFHUSBAND/WIFE:
UMA CHARAN GUPTA
67 YEARS
TTT TT/ HUSBAND/WIFE AADHAAR NO. :
NAME OF MOTHER: 9T TT/ NAME OF FATHER:
ATeTT T MOTHER'S AADHAAR NO. : 3HTTT A4T FATHER'S AADHAAR NO. :

1 ADDRESS OFTHE DECEASED AT THETIME OFDEATH: T IPERMANENT ADDRESS OF DECEASED

SWAMI JI CHAURAHA SWAMI JI CHAURAHA
MUKHTYARGANJ, SATNA, RACHURAJNAGAR, SATNA, MUKHTYARGANJ, SATNA, RAGHURAJNAGAR, SATNA,
MADHYA PRADESH MADHYA PRADESH
Ti ET /REGISTRATION NO: TsiteBo ars/DATE OE REGISTRATION:
D-2021: 23-90092-001476 08-09-2021
fcyoii /REMARKS (IF ANY):
RN.-1495/06.09.2021

T /DATE OF ISSUE
08-09-2021 TT IURGIR*
SUING AUTHORITY
REGTaR
MUNICOR C8RSRHENSAaNA
UPDATED ON:
08-09-2021 15:37:42

THIS ISA
COMPUTER GENERATED
THE GOVT. OF INDIA VIDE CIRCULAR NO. CERTIFICATE.
1/12/2014-Vs(CRS) DATED "27-JULY-2015 HAS
AROVEOTHIS CERTIFICATR AS A VALID LEGAL DoUCMENT FOR ALL OFFICIAL PURPOSES.
4 *S t Asio N A T " 1 E N s U R E RGISTRATION OF EVERY BIRTHAND DEATH"