FORM NO. 6 |
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| This is to certify that the following information has been taken from the original record of death which is the register for (Local Area)
…………………... …….…………………………………………..of Tahsil
……………………………… of District …………………………….. …… of State ……………….. Name …………………………………………….. Sex ……………………………………………….. Date of Death ……………………………………... Place of Death …………………………………….. Registration No. …………………………………... Date of Registration ……………………………..… Date ………………….. Signature of Issuing Authority Seal __________________________________________________________________________________ No disclosure shall be made of particulars regarding the cause of death as entered in the Register. See proviso to Section 17(1) D/P&S -- No. 811/28-4-2000 – Medical – 20,000 –C/15-5-2000. |
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