You are on page 1of 5

Death report for the period 01/04/2016 To 01/07/2016

Sl. No. Registration No. Date of Reporting Date of Registration Date of Death
6
Age Of Deceased Format Of Death Sex Deceased Name Father Name Mother Name
Spouse Spouse Age Spouse contact Details
Address of deceased at the time of death Permanant Address of Deceased
Place of D Address of Informant Address ofRemarks

You might also like