సంఖ 1

No. 1
ఆంధ పే పభుతము ారం-6
GOVERNMENT OF ANDHRA PRADESH FORM-6
ైద,ఆోగ మియు టుంబ సంేమ ాఖ
DEPARTMENT OF HEALTH, MEDICAL AND FAMILY WELFARE

MUNICIPAL CORPORATION TIRUPATI

మరణ ధృవ పతము

DEATH CERTIFICATE

(జనన మరణ నదు చటం 1969, 12/17 గము పారము, ఆంధ పే జనన మరణ నదు బంధనలు 1999, 8/13 ింద ాీేయడైని)

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

ఈ ింి సమాా మరణం నదు క అసలు ిారు ాషం క... ముిపల ాొేష రుప . రుప అరలా .. తూరు ాలూా / బా ుంి సుోబింి అ
సరిౖ ేయడం
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER FOR
MUNICIPAL CORPORATION TIRUPATI OF TAHSIL/BLOCK TIRUPATI URBAN OF DISTRICT CHITTOOR OF STATE/UNION TERRITORY ANDHRA PRADESH, INDIA.

మరణింన వి రు / NAME OF DECEASED : K HARINATH ంగము / SEX: पुरुष / MALE

ఆా సంఖ / AADHAAR NO.:

XXXXXXXX4704

మరణింన ేి / DATE OF DEATH: మరణింన పేశం / PLACE OF DEATH:

21-12-2021 HELIOS HOSPITAL TIRUPATI
TWENTY-FIRST-DECEMBER-TWO THOUSAND TWENTY ONE
భర / ర రు / NAME OF HUSBAND / WIFE:
K RATHNAMMA
మరణింన వి క వయసు / AGE OF DECEASED:
71 YEARS ఆా సంఖ / HUSBAND/WIFE AADHAAR NO. :
5886 9777 0370

తలి రు / NAME OF MOTHER: తంి రు / NAME OF FATHER :

KODURU NARAYANAMMA KODURU GOVINDHAIAH

ఆా సంఖ / MOTHER'S AADHAAR NO. :

--- ఆా సంఖ / FATHER'S AADHAAR NO. :
---

మరణింనపడు మృతు రుామ / ADDRESS OF THE DECEASED AT THE TIME OF DEATH : మృతు ిరాసప రుామ / PERMANENT ADDRESS OF DECEASED
:
6-659/A, P.K LAYOUT , P K LAYOUT,
TIRUPATI, TIRUPATI URBAN, CHITTOOR, 6-659/A, P.K LAYOUT, P K LAYOUT,
ANDHRA PRADESH- 517501 TIRUPATI, TIRUPATI URBAN, CHITTOOR,
ANDHRA PRADESH- 517501

నదు సంఖ / REGISTRATION NO: నదు ేీ / DATE OF REGISTRATION:

D-2021: 28-90076-007221 27-12-2021

ేాంశములు / REMARKS (IF ANY):

---

ాీ ేిన ేి / DATE OF ISSUE: ాి ేిన అిాి సంతకం / ISSUING AUTHORITY
28-12-2021
(జనన మరణ ిషా)
REGISTRAR (BIRTH & DEATH)
MUNICIPAL CORPORATION TIRUPATI

UPDATED ON :
2021-12-27

"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 DOUCMENT FOR ALL OFFICIAL PURPOSES.

" ప జననము, ప మరణము తపంా 21 ోలలో నదు ేయంి" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "