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SignedDeathCertificate
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Form-6
Share this document GOVERNMENT OF WEST BENGAL
DEPARTMENT OF HEALTH AND FAMILY WELFARE

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KOLKATA MUNICIPAL CORPORATION

DEATH CERTIFICATE

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(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE WEST BENGAL
REGISTRATION OF BIRTHS & DEATHS RULES 2000.)

THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS


THE REGISTER FOR KOLKATA MUNICIPAL CORPORATION OF BLOCK/MUNICIPALITY KOLKATA MUNICIPAL CORPORATION OF
DISTRICT KOLKATA OF STATE WEST BENGAL, INDIA.

NAME OF DECEASED : HARIGOPAL DEY SEX : MALE

DATE OF DEATH : Email 09/08/2023 PLACE OF DEATH : R. G.KAR MEDICAL COLLEGE &
HOSPITAL, KOLKATA MUNICIPAL
CORPORATION, KOLKATA, WEST
BENGAL

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AGE OF DECEASED : 66 YEARS
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NAME OF SPOUSE :

SPOUSE IDENTITY PROOF. : -

NAME OF MOTHER : NAME OF FATHER : LATE NARAYAN DEY

MOTHER'S IDENTITY PROOF : - FATHER'S IDENTITY PROOF : -

ADDRESS OF THE DECEASED AT STREET/LANE:- DEARA,LOCALITY:-PO RAJARHAT PS MADHYAMGRAM, VILLAGE/TOWN:- DEARA

THE TIME OF DEATH : (CT),BARASAT - II,DIST:- NORTH 24 PARGANAS,WEST BENGAL-700135

PERMANENT ADDRESS OF STREET/LANE:-DEARA,LOCALITY:-PO RAJARHAT PS MADHYAMGRAM, VILLAGE/TOWN:- DEARA

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DECEASED : Report
(CT), BARASAT - II,DIST:- NORTHthis Document
24 PARGANAS,WEST BENGAL-700135

CERTIFICATE NO : D/2023/406333 DATE OF REGISTRATION : 09/08/2023

REMARKS (IF ANY) :

DATE OF ISSUE : 09/08/2023 ISSUING AUTHORITY :

UPDATED ON : 2023-08-09 15:50:29

Signature Not Verified

Digitally Signed.
Name: BHASKAR DAS
Date: 09-Aug-2023 15:52:24

SUB-REGISTRAR (BIRTH & DEATH)

KOLKATA MUNICIPAL CORPORATION

"THIS IS A COMPUTER GENERATED CERTIFICATE."

THE GOVT.OF INDIA VIDE CIRCULAR NO. 1 / 12 / 2014 - VS(CRS) DATED 27 - JULY - 2015
HAS APPROVED THIS CERTIFICATE AS A VALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES

"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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