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

GRAMA PANCHAYAT CHILAKAPADU

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... ామ పంాయ లకాడు . సంతనూతల పడులా .. పాశం ా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 GRAMA
PANCHAYAT CHILAKAPADU OF TAHSIL/BLOCK SANTHANUTHALA PADU OF DISTRICT PRAKASAM OF STATE/UNION TERRITORY ANDHRA PRADESH, INDIA.

మరణింన వి రు / NAME OF DECEASED : REPURI SUBBULU / REPURI SUBBULU ంగము / SEX: महिला / FEMALE

ఆా సంఖ / AADHAAR NO.:

XXXXXXXX6763

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

20-05-2023
TWENTIETH-MAY-TWO THOUSAND TWENTY THREE ౩౫-౨-164, CHILAKAPADU, BMACHAVARAB, , సంతనూతల పడు, పాశం , , 523225. /
CE½B½AFD, CHILAKAPADU, BMACHAVARAB, CHILAKAPADU, SANTHANUTHALA PADU,
PRAKASAM, ANDHRA PRADESH, 523225.
మరణింన వి క వయసు / AGE OF DECEASED:
84 YEARS భర / ర రు / NAME OF HUSBAND / WIFE:
REPURI KRUPARAO / REPURI KRUPARAO

ఆా సంఖ / HUSBAND/WIFE AADHAAR NO. :

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

INDLA PICHAMMA / INDLA PICHAMMA INDLA KOTAIAH / INDLA KOTAIAH

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 మృతు ిరాసప రుామ / PERMANENT ADDRESS OF DECEASED :
DEATH : ౩౫-౨-164, CHILAKAPADU,
౩౫-౨-164, CHILAKAPADU, BMACHAVARAM, సంతనూతల పడు, పాశం ,
BMACHAVARAM, సంతనూతల పడు, - 523225
523225
CE½B½AFD, CHILAKAPADU, CHILAKAPADU, SANTHANUTHALA PADU, PRAKASAM,
BMACHAVARAM, CHILAKAPADUSANTHANUTHALA PADU, PRAKASAM, ANDHRA PRADESH- 523225
ANDHRA PRADESH- 523225

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

D-2023: 28-07521-000009 26-05-2023

ేాంశములు / REMARKS (IF ANY):

NILL

ాీ ేిన ేి / DATE OF ISSUE: ాి ేిన అిాి సంతకం / ISSUING AUTHORITY
27-06-2023
(జనన మరణ ిషా)
REGISTRAR (BIRTH & DEATH)
GRAMA PANCHAYAT CHILAKAPADU

UPDATED ON :
2023-05-26 12:15:03

"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 "