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Sor NSTETUTES FOR MEDICAL SCIENCE
‘No.1, Jawaharlal Nehru Salai (100 Feet Road), Vadapalani, Chennai - 600 026.
DEATH CERTIFICATE
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of / 2023
UHID No 22144 Date
‘Time
‘Name of the Deceased
Slo. / D/o. / Spouse Name
Address :
Cause of Death.
Certifying Doctor’s Name :
Registrationn Number :
Signature of the Certifying Doctor :
Note : This certificate is issued to take the Dead Body during transportation and for cremation
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HASHMIYA KAREEM
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2028-01-11 2020-01-12 Karbalaal+
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