OFFICE OF DHAKA, BANGLADESH

File No.
STATE BOARD OF HEALTH 1640189691
CERTIFICATE OF DEATH

01. PLACE OF DEATH: 02. NAME OF DECEASED: 03. SEX:

Dhaka, Bangladesh Imon Hussain M
04. COLOR OR RACE: 05. MARITAL STATUS: 06. DATE OF BIRTH:
White Single 1987-09-10
07. OCCUPATION: 08. BIRTHPLACE: 09. DATE OF DEATH:
Unemployed Dhaka, Bangladesh 2021-12-19
10. PLACE OF BURIAL: 11. UNDERTAKER:
Dhaka, Bangladesh Ziaul Islam