D55835814015680249/2023

Zone 05 Division 59A

Name AMALA.M

Sex Female
Date of Death 01/01/2023
Age 32 YEARS
Place of Death RAJIV GANDHI GOVT. GENERAL HOSPITAL PH ROAD, PARK TOWN,
CHENNAI-600003

Name of The Mother SHAMALA.M

Name of The Father MOSES

Name of The Husband / Wife DANTHAM SAMUEL RAJ

Address of the deceased at the time , TAMIL NADU
of death

Permanent Address Of The Deceased , NO.10/7, KURAVAN KULAM 2ND STREET, CHOOLAI, CHENNAI,
TAMIL NADU -600112

D-2023:33-16549-000421
Registration Number
Date of Registration 19/01/2023

Remarks (If Any)

Date of Issue 30/01/2023

Signature Not Verified

Digitally Signed by U.PRADEEP
Date: 30-Jan-2023 (15:54:38)

Registrar of Births & Deaths,

30/01/2023 Division :59A Zone : 05

Greater Chennai Corporation

The authenticity of this certificate can be verified at www.chennaicorporation.gov.in.

The Registration Number is unique to each death. Ensure Registration of every Birth and Death