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 KARAKAMPALLE

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... కరకంపలె . తవనంపలెలా .. తూరు ా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 KARAKAMPALLE OF TAHSIL/BLOCK THAVANAMPALLE OF DISTRICT CHITTOOR OF STATE/UNION TERRITORY ANDHRA PRADESH, INDIA.

మరణింన వి రు / NAME OF DECEASED : P DORASWAMY ంగము / SEX: पुरुष / MALE

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

19-09-2023 4-33, E KARAKAMPALLE, KARAKAMPALLE, THAVANAMPALLE,
NINETEENTH-SEPTEMBER-TWO THOUSAND TWENTY THREE CHITTOOR, ANDHRA PRADESH, 517131.

భర / ర రు / NAME OF HUSBAND / WIFE:

మరణింన వి క వయసు / AGE OF DECEASED: P LAKSHMAMMA
77 YEARS
ఆా సంఖ / HUSBAND/WIFE AADHAAR NO. :

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

LATE AMMENAMMA LATE P MUNEIAH

ఆా సంఖ / MOTHER'S AADHAAR NO. :

--- ఆా సంఖ / FATHER'S AADHAAR NO. :
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మరణింనపడు మృతు రుామ / ADDRESS OF THE DECEASED AT THE TIME OF మృతు ిరాసప రుామ / PERMANENT ADDRESS OF DECEASED
DEATH : :

4-33, E KARAKAMPALLE, 4-33, E KARAKAMPALLE,

KARAKAMPALLE, THAVANAMPALLE, CHITTOOR, KARAKAMPALLE, THAVANAMPALLE, CHITTOOR,
ANDHRA PRADESH- 517131 ANDHRA PRADESH- 517131

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

D-2023: 28-12430-000009 19-10-2023

ేాంశములు / REMARKS (IF ANY):

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ాీ ేిన ేి / DATE OF ISSUE: ాి ేిన అిాి సంతకం / ISSUING AUTHORITY
19-10-2023
(జనన మరణ ిషా)
REGISTRAR (BIRTH & DEATH)
GRAMA PANCHAYAT KARAKAMPALLE

UPDATED ON :
2023-10-19 10:27:24

"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 "