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    CHHEDDU

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    Divyansh Singh 11A
    This document is a death certificate from the Grama Panchayat Fatehnagar Karsuma in Uttar Pradesh, India. It certifies the death of Chheddu, a 68-year old male who died on November 25th, 2022 in Fatehnagar Karsuma. The certificate provides details of the deceased such as name, age, address, names of parents, date of registration, and was issued on December 10th, 2022 by the Registrar of Births and Deaths of the Grama Panchayat Fatehnagar Karsuma.

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    © All Rights Reserved
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    CHHEDDU

    Uploaded by

    Divyansh Singh 11A
    189 views1 page
    This document is a death certificate from the Grama Panchayat Fatehnagar Karsuma in Uttar Pradesh, India. It certifies the death of Chheddu, a 68-year old male who died on November 25th, 2022 in Fatehnagar Karsuma. The certificate provides details of the deceased such as name, age, address, names of parents, date of registration, and was issued on December 10th, 2022 by the Registrar of Births and Deaths of the Grama Panchayat Fatehnagar Karsuma.

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    © © All Rights Reserved

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    This document is a death certificate from the Grama Panchayat Fatehnagar Karsuma in Uttar Pradesh, India. It certifies the death of Chheddu, a 68-year old male who died on November 25th, 2022 in Fatehnagar Karsuma. The certificate provides details of the deceased such as name, age, address, names of parents, date of registration, and was issued on December 10th, 2022 by the Registrar of Births and Deaths of the Grama Panchayat Fatehnagar Karsuma.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    189 views1 page

    CHHEDDU

    Uploaded by

    Divyansh Singh 11A
    This document is a death certificate from the Grama Panchayat Fatehnagar Karsuma in Uttar Pradesh, India. It certifies the death of Chheddu, a 68-year old male who died on November 25th, 2022 in Fatehnagar Karsuma. The certificate provides details of the deceased such as name, age, address, names of parents, date of registration, and was issued on December 10th, 2022 by the Registrar of Births and Deaths of the Grama Panchayat Fatehnagar Karsuma.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 1

    सं.

    1
    No. 1
    उर देश सरकार प-6
    GOVERNMENT OF UTTAR PRADESH FORM-6
    चकसा एवं वाय वभाग
    DEPARTMENT OF MEDICAL AND HEALTH
    ाम पंचायत फतेहनगर करसीमा
    GRAMA PANCHAYAT FATEHNAGAR KARSUMA

    मृयु माण-प
    DEATH CERTIFICATE

    (जम मृयु रिजकरण अधनयम , 1969 क धारा 12 / 17 तथा उर देश जम मृयु रिजकरण नयम, 2002 के नयम 8/13 के अंतगत जार कया
    गया )
    (ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE UTTAR PRADESH
    REGISTRATION OF BIRTHS & DEATHS RULES 2002.)

    यह मािणत कया जाता है ननलिखत सूचना मृयु के मूल अभलेख से ल गई है जो क ाम पंचायत फतेहनगर करसीमा तहसील फतेहपुर िजला फतेहपुर
    राय/संघ देश उर देश,भारत के रिजटर म उिलिखत है ।
    THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER
    FOR GRAMA PANCHAYAT FATEHNAGAR KARSUMA OF TAHSIL/BLOCK FATEHPUR OF DISTRICT FATEHPUR OF STATE/UNION TERRITORY UTTAR
    PRADESH, INDIA.

    मृतक का नाम / NAME OF DECEASED : CHHEDDU लंग / SEX: पुरष / MALE

    मृयु क तथ / DATE OF DEATH: मृयु का थान / PLACE OF DEATH:


    25-11-2022 FATEHNAGAR KARSUMA, CHURIYANI, FATEHNAGAR KARSABHA,
    TWENTY-FIFTH-NOVEMBER-TWO THOUSAND TWENTY TWO FATEHPUR, FATEHPUR, UTTAR PRADESH, 212601.

    पत / पी का नाम / NAME OF HUSBAND / WIFE:


    मृतक क उ / AGE OF DECEASED: RAMA DEVI
    68 YEARS
    आधार नंबर / HUSBAND/WIFE AADHAAR NO. :

    माता का नाम / NAME OF MOTHER: पता का नाम / NAME OF FATHER :


    DHANDHU

    आधार नंबर / MOTHER'S AADHAAR NO. : आधार नंबर / FATHER'S AADHAAR NO. :

    मृयु के समय मृतक का पता / ADDRESS OF THE DECEASED AT THE TIME OF मृतक का थायी पता / PERMANENT ADDRESS OF DECEASED :
    DEATH :
    FATEHNAGAR KARSUMA,
    FATEHNAGAR KARSUMA, CHURIYANI, BALIPUR, FATEHPUR, FATEHPUR,
    CHURIYANI, BALIPUR, FATEHPUR, FATEHPUR, UTTAR PRADESH- 212601
    UTTAR PRADESH- 212601

    पंजीकरण संया / REGISTRATION NO: पंजीकरण तारख / DATE OF REGISTRATION:


    D-2022: 9-25560-000019 10-12-2022

    टपणी / REMARKS (IF ANY):


    ---

    जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY
    10-12-2022
    रिजार (जम एवं मृयु)
    REGISTRAR (BIRTH & DEATH)
    ाम पंचायत फतेहनगर करसीमा
    GRAMA PANCHAYAT FATEHNAGAR KARSUMA

    UPDATED ON :
    10-12-2022 12:04:10

    "THIS IS A COMPUTER GENERATED CERTIFICATE. "


    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.
    " येक जम एवं मृयु का पंजीकरण सुनचत कर" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "

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