Primary and Secondary Health Care Department

DHQ Hospital Khushab at Jauharabad.

DEATH CERTIFICATE

Department : Unit :

Patient Name :
S/O, D/O, W/O :
Age : Sex :
Registration Number :
Diagnosis :
Operation/Treatment :
Date of Admission : Time of Admission :
Date of Death : Time of Death :
Cause of Death :
Body Recieved By :
CNIC : - -
Relation With Deceased : Signatures :

Signature Of M.O :
Name Of M.O :
DHQ Hospital :
Date :