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ES19512818
ES19512818
No : ES19512818
ਚੀਫ ਰਸਜਸਟਰਾਰ ਜਨਮ ਤੇ ਮੌਤ, ਪੰ ਜਾਬ/Chief Registrar (Birth & Death), Punjab
ਮੌਤ ਦਾ ਸਰਟੀਸਫਕੇਟ/Death Certificate
ਡੀ ਪੀ ਐਚ /D.P.H - 369
ਫਾਰਮ / Form - 7
This is to certify that following information has been taken from the original death record which is registered in the birth
register of Local Registrar, Birth & Death, Municipal Corporation Patiala, Tehsil Patiala, District Patiala of Punjab State
for the year 2017.
ਰਜਿਸਟਰੇਸ਼ਨ ਦ ਜਮਤ /Date of Registration: 09/01/2017 ਸਦਭਾਵਨਾ ਹਸਪਤਾਲ, ਪਸਟਆਲਾ / SADBHAVNA HOSPITAL,
PATIALA
ਜਮਤ ਦ ਮਤ ਸਮ ਪਤ / ਜਮਤ ਦ ਪ ਪਤ /
Address of Deceased at the time of death Permanent Address of the Deceased
Note:- Issued u/s 17 of the Registration of Births and Deaths Act, 1969 and rules 13 the Punjab Registration of Births and Deaths Rules 2004.
Designation: EOMC
1. The authenticity of this document can be verified using document serial number at the web link 'https://esewa.punjab.gov.in/certificateVerification'
or by scanning QR code. Any discrepancy in details on this document as compared to those available on the verification web link renders this
document invalid.
2. This is a digitally signed certificate and doesn't require physical signature, or hologram, or stamp as per Punjab Government Notification no.
E122499/GRMC/172 Dated: 31-08-2022, available at 'https://punjab.gov.in'
3. The responsibility of verification of this document before accepting the same for any legal purposes would rest with the Institution / Organization /
Company or any other Entity where this document is produced.
4. This certificate is valid as per Information Technology Act 2000 as amended from time to time.
5. In case of any discrepancy, please inform the issuing authority about the discrepancy in the certificate.
.
********** Print Date 12/04/2024