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    This document is a death certificate issued under the Registration of Births and Deaths (RBD) Act of 1969 and RBD Rules of 1999 in Karnataka, India. It certifies the following information was taken from the original register of death: [1] Name, [2] Age, [3] Date of death, [4] Place of death, [5] Name of mother, [6] Name of father, [7] Name of husband/wife, [8] Permanent address of deceased, [9] Address at time of death, [10] Registration number, [11] Date of registration, [12] Any remarks, [13] Date of issue, [14] Address

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    This document is a death certificate issued under the Registration of Births and Deaths (RBD) Act of 1969 and RBD Rules of 1999 in Karnataka, India. It certifies the following information was taken from the original register of death: [1] Name, [2] Age, [3] Date of death, [4] Place of death, [5] Name of mother, [6] Name of father, [7] Name of husband/wife, [8] Permanent address of deceased, [9] Address at time of death, [10] Registration number, [11] Date of registration, [12] Any remarks, [13] Date of issue, [14] Address

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    © All Rights Reserved
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    3 views1 page

    Sidd Death

    Uploaded by

    ASHOK
    This document is a death certificate issued under the Registration of Births and Deaths (RBD) Act of 1969 and RBD Rules of 1999 in Karnataka, India. It certifies the following information was taken from the original register of death: [1] Name, [2] Age, [3] Date of death, [4] Place of death, [5] Name of mother, [6] Name of father, [7] Name of husband/wife, [8] Permanent address of deceased, [9] Address at time of death, [10] Registration number, [11] Date of registration, [12] Any remarks, [13] Date of issue, [14] Address

    Copyright:

    © All Rights Reserved
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    of 1

    sabes-6

    Form-6
    No,

    Government of Indla

    GOVERNMENT OF KARNATAKA

    Chief Registrar of Births and Deaths

    Joioaorde,
    (8.0.8at. ed0oao, 1969d 12/17toto ydco aoerke .a.o.&ot
    1999 aibso 8/13d soedr tadeod)
    DEATH CERTIFICATE
    of the KRBD Rules, 1999)
    (Issued under Section 12/17 of the RBD Act, 1969 and Rule 8/13

    doop

    following information has, been taken from the original


    This is to certify that the9 ne.... (village/town) of
    of death which is the register
    rcorg
    -.91E2a.....aluk of.. of Karnataka State.
    ...district

    (2) Oord
    (1) sido Sex
    Name
    (4) Place
    odce of&
    Death.f05,
    (3) sodcs Do
    Date of Death .aLeelLa8..
    (6) soo SIo
    ,
    Name of Motherob Name ofthe Father.
    (5) cuado id

    () dos |dodso oo
    Name of the Husband/Wife....
    (9) , d arDabo Jrer
    Permanent address of the deceased
    Address of the deceased at the
    time of deah:
    ...3ZAfr..S).
    ...Eylia.C. (11) toeots' eou:
    (10) aeodo
    Registration Date ofRegistration 5/o6.
    (13) eNBs ea Bo:
    (12) toe (odejoca a )
    Remarks(if any) . Date of issue
    eo
    (15) co a o o
    Address uing uthority
    Signature of the issuing authority
    BeBco/ Seal

    death"
    "Ensure registration of every birth and
    Register. See proviso to Section 17(1).
    regarding the cause of death as entered in the
    Nodisclosure shall be made of particulars

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