Que@ser Aesroner onEenTA GREATER CHENNAI CORPORATION Gurg! sarsrTsgieop p53745098452458710/2021 DEPARTMENT OF PUBLIC HEALTH FORN-NO:6,uipuli avai :6 (G00 08a 6 ura) DEATH CERTIFICATE / @imix aren igib (ISSUED UNDER SECTION 12/17 OF REGISTRATION OF BIRTH AND DEATH ACT (969 hoy I LY uly BC TO6S-sr Mi DAT crip ayEULL 5) This ist certify thatthe flowing infomation hes been taken fom the agin record of death ofthe Greater Chernal (Corporation ofthe State of Tami Ned, India Eijacin. gsasbade pion, Cugsar Gackom urgage’ A 0 Goi ufo yelgigi etn La a srg aupiiuGpg. Zone 94 Division 034 Name MSIRAJUDEEN Sex Male Date of Death 04/0112021 Age 63 YEARS Place of Death NO.68/8, PALPANNAl SALAI PARVATHY NAGAR CHENNA| -600081 Name of The Mother DAWOOD MARIUM Name of The Father MAIDEEN PITCHAI Name of The Husband / Wife SAIDHA BEGUM ‘Address of the deceased at the time _NO.6B/8, PALPANNAI SALAI PARVATHY NAGAR, CHENNAL, , TAMIL of death NADU -600081 Permanent Address Of The Deceased “NO.68/8, PALPANNAI SALAI PARVATHY NAGAR, CHENNAI, , TAMIL NADU. 600081 Registration Number -2021:33-16338-000012 Date of Registration r202t Remarks (If Any) Date of Issue osio2iz021 Signature Registrar of Births & Deaths, Division :034 Zone : 04 Greater Chennai Corporation ‘The authenticity ofthis certificate can be verified at www.chennaicorporation.gov.in. The Registration Number is unique to each birth. Ensure Rgistration of every Birth and Death