Form NO.

10
Death Certificate No: JK-ULB/20242054

UNION TERRITORY OF JAMMU AND KASHMIR

OFFICE OF THE REGISTRAR BIRTHS AND DEATHS
BHADERWAH MUNICIPAL CORPORATION
DEATH CERTIFICATE

BHADERWAH MUNICIPAL CORPORATION

Of Tehsil: BHADERWAH
Of District: DODA
Of Union Territory: JAMMU AND KASHMIR

Name of Deceased : KESHAV SINGH BALORIA Gender : MALE

Date of Death
Husband’s/Wife’s Name
Place of Death
Address of Deceased
Registration No.
: 23-01-2024 Date of Issue :01-02-2024
: Late JYOTI DEVI
: JAMMU & KASHMIR
: WARD NO 2, KURSARI UDRANA, BHADERWAH
: 05067

Date of Registration : 27/01/2024

Certificate No:- JK-ULB/20242054

Certified By:

Name: Dr. Shruti Kotwal

Designation: Registrar

Note: This is a Digitally Signed Certificate, does not required physical signature.