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This document is a death certificate for Raj Kumari Devi: 1) The certificate provides details of Raj Kumari Devi such as her name, age (77 years old), sex (female), date of death (September 12, 2016), place of death (Tata Main Hospital), and address. 2) It also includes information about her husband (M.P. Singh) and confirms that the details listed were taken from the original record of death registered in Jamsedpur Notified Area Committee. 3) The certificate was issued on September 14, 2016 and contains the registration number and other identifying information to validate it.

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Sanjay Kumar
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1K views

Question Booklet

This document is a death certificate for Raj Kumari Devi: 1) The certificate provides details of Raj Kumari Devi such as her name, age (77 years old), sex (female), date of death (September 12, 2016), place of death (Tata Main Hospital), and address. 2) It also includes information about her husband (M.P. Singh) and confirms that the details listed were taken from the original record of death registered in Jamsedpur Notified Area Committee. 3) The certificate was issued on September 14, 2016 and contains the registration number and other identifying information to validate it.

Uploaded by

Sanjay Kumar
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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.


GOVERNMENT OF JHARKHAND

No. 1

-6
FORM-6


DEPARTMENT OF PLANNING AND DEVELOPMENT

JAMSHEDPUR NOTIFIED AREA COMMITTEE

-
DEATH CERTIFICATE
( , 1969 12 / 17 , 2009 8/13 )
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE JHARKHAND REGISTRATION OF BIRTHS & DEATHS
RULES 2009.)

-
/ ,
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER FOR JAMSHEDPUR
NOTIFIED AREA COMMITTEE OF TAHSIL/BLOCK GOLMURI-CUM-JUGSALAI OF DISTRICT PURBI SINGHBHUM OF STATE/UNION TERRITORY JHARKHAND, INDIA.

/ NAME OF DECEASED : RAJ KUMARI DEVI

/ SEX: / FEMALE

/ DATE OF DEATH:
12-09-2016
TWELFTH-SEPTEMBER-TWO THOUSAND SIXTEEN

/ PLACE OF DEATH:
TATA MAIN HOSPITAL

/ AGE OF DECEASED:
77 YEARS

/ / NAME OF HUSBAND / WIFE:


LATE M. P SINGH
/ / HUSBAND/WIFE UID NO. :
---

/ NAME OF MOTHER:

/ NAME OF FATHER :

/ MOTHER'S UID NO. :


---

/ FATHER'S UID NO. :


---

/ ADDRESS OF THE DECEASED AT THE TIME OF DEATH : / PERMANENT ADDRESS OF DECEASED :


B-10,ROAD NO 6,RAJU BAGAN, WEST KITADIH,TATA NAGAR ,JSR,
JAMSHEDPUR (NAC), GOLMURI-CUM-JUGSALAI, PURBI SINGHBHUM,
JHARKHAND

JAMSHEDPUR (NAC)GOLMURI-CUM-JUGSALAI, PURBI SINGHBHUM,


JHARKHAND

/ REGISTRATION NO:
D-2016: 20-90019-003536

/ DATE OF REGISTRATION:
14-09-2016

/ REMARKS (IF ANY):


---

/ DATE OF ISSUE:
14-09-2016

/ ISSUING AUTHORITY
( )
REGISTRAR (BIRTH & DEATH)
JAMSHEDPUR NOTIFIED AREA COMMITTEE

UPDATED ON :
2016-09-14

"THIS IS A COMPUTER GENERATED CERTIFICATE WHICH CONTAINS FACSIMILE SIGNATURE OF THE ISSUING AUTHORITY"
THE GOVT. OF INDIA VIDE CIRCULAR NO. 1/12/2014-VS(CRS) DATED 27-JULY-2015 HAS
APPROVED THIS CERTIFICATE AS A VALID LEGAL DOUCMENT FOR ALL OFFICIAL PURPOSES.
THE AUTHENTICITY OF THIS CERTIFICATE CAN BE VERIFIED FROM THE WEBSITE CRSORGI.GOV.IN.
THE REGISTRATION NUMBER IS UNIQUE TO EACH EVENT.
" " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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