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Na 97-6
GoVERNMENT OF MADHYA PRADESH FORM-6

DEPARTMENT OF PLANNING, ECONOMICS & STATISTICS

MUNICIPAL CORPORATION BHOPAL

ATor-y7
DEATH CERTIFICATE

(ISSUED ÜNDER `ECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS 1969 AND RULE 8/13 OF THE MADHYA PRADESH REGISTRATION OF BIRTHSs
& DEATHS RULES 1999.)

THIS IS TOCERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROMTHEORIGINAL RECORD OF DEATH WHICHIS THE REGISTER FOR
MUNICIPAL CcORPORATION BHOPAL OF TAHSIL/BLOCK HUZUR OF DISTRICT BHOPAL OF STATE/UNION TERRITORY MADHYA PRADESH, INDIA.

T T /NAME OF DECEASED :T A T UYTS / CHANDRAKALA DHAPADE feT SEX: HteT| FEMALE

TUTT TT AADHAAR NO.:
XXXXxxxoK5808

Tfaf IDATE OF DEATH: T FYTT /PLACE OF DEATH:

29-03-2021
TWENTY-NINTH-MARCH-TWO THOUSAND TWENTY ONE H/12. PRASHASAN ACADMY 100 QUATER, BHOPAL, HUZUR. BHOPAL
MADHYA PRADESH, 462016. TT/R, TATRIT FOIGT ??oo arTT,
TTT, , AT, qET eY, 462016.
z 3 IAGEOF DECEASED:
55 YEARS uT TaT AT NAME OF HUSBAND / WIFE:
e r u r s / TILAKCHAND DHAPADE

HUSBAND/wIFE AADHAAR NO. :

HTgI T7 NAME OF MOTHER: T9MT TTA NAME OF FATHER:

YASHODA BAREWAR THIT T T CHUVALAL BAREVAR
sATITT T MOTHER'S AADHAAR NO. : zmTa T / FATHER'S AADHAAR NO.
T z ADDRESS OF THE DECEASED ATTHE TIME OF DEATH: T R T d VAT/PERMANENTADDRESS OF DECEASED:
H/12, PRASHASAN ACADMY 1100 QUATER,
HUZUR, BHOPAL MADHYA PRADESH- 462016 H/12, PRASHASAN ACADMY 1100 QUATER, BHOPAL, HUZUR, BHOPAL,
BHOPAL, MADHYA PRADESH- 462016
HT9T, , HUIG,
HE - 462016
462016

Tait57 ET /REGISTRATION NO: voiteor r a / DATE OF REGISTRATION

D-2021: 23-90235-005747 22-04-2021

feuot /REMARKS(IF ANY):

COPY

T faf DATE OP1SSUE: rt a r T HfeTET IssUING AUTHORITY

04-05-2021
REGISTRAR (BIRTH &bEATH)
MUNICIPAL CORPORATION BHOPAL

UPDATED ON
22-04-2021 00:00:00

THIS IS ACOMPUTER GENERATEDCERTIPICATEWHICHCONTAINS PACSIMILE SICNATURE OF THE ISSuING AUTHORITT

THE GOVT. OF INDIA VIDE CIRCULAR NO. 1/12/r2014-VS(CRS) DATED 27JULY-2015 HAS
APPROYED THIS CERTIPICATE AS A VA;ID LEGAL DOUCMENT FOR ALL OFFICIAL PURPOSES.
XE H vi Fg «T YSt7r zyfarfer **/ ENSURE REGISTRATION OFEVERYBRTIH AND DEATII"