D.P.H. – 368 Form No.

10
(See Rule 9)

DEATH CERTIFICATE
Chief Registrar (Birth & Death)
Punjab, Chandigarh
It is certified that the Information written below has been taken from the original Birth Record
which is registered in the Register of Local Registrar Birth & Death MUNICIPAL
COMMITTEE, LUDHIANA, Tehsil LUDHIANA District LUDHIANA State Punjab.

Name : Sukhdev Singh Permanent Address : H no. 246-A Model town extension
Ludhiana (Pb)
Father’s Name : Chanan Singh

Nationality : Indian

Sex : Male

Date of Death : 09/01/2024 Registration No. : 67

Place of Death : Ludhiana Date of Registration : 13/02/2024

Certificate preparing person’s Signature Certificate issuing person’s Signature

Name : Kulwant

Name : Jaswant Singh Stamp

Local Registrar, Birth & Death

Municipal Committee, Ludhiana

Date : 19/02/24

Note :- This Certificate (Death) has been issued under the Birth & Death Registration Act 1969
(India Govt.) Section 12/17. What cause of death has been told in the Death register, That
information will not be given in the Death Certificate