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Death Certificate

This death certificate certifies the death of JEMINI.O.R, a 15-year-old male who died on January 15, 2007 at Lakeshore Hospital & Research Center Ltd. in Nettoor. The deceased's mother is SUJATHA.A.L. and his father is RAVI.O.G. The certificate was issued on July 2, 2019 by the Registrar of Births and Deaths of Maradu Municipality. It notes that the original records did not contain the column for the deceased's present address.

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Biju Cp
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4K views1 page

Death Certificate

This death certificate certifies the death of JEMINI.O.R, a 15-year-old male who died on January 15, 2007 at Lakeshore Hospital & Research Center Ltd. in Nettoor. The deceased's mother is SUJATHA.A.L. and his father is RAVI.O.G. The certificate was issued on July 2, 2019 by the Registrar of Births and Deaths of Maradu Municipality. It notes that the original records did not contain the column for the deceased's present address.

Uploaded by

Biju Cp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form - 6

Key No. D0021247-07011913063


FORM No.6
(See Rule 8)
tIcf kÀ¡mÀ
GOVERNMENT OF KERALA
\KcImcy hIp¸v
DEPARTMENT OF URBAN AFFAIRS
kÀ«n^n¡äv \ðIp¶ Xt±iØm]\¯nsâ t]cv acSv ap\nkn¸menÁn
Name of Local Government issuing certificate Maradu Municipality
acW kÀ«n^n¡äv
DEATH CERTIFICATE
(Issued Under Section 12)

(1969þse P\\þacW cPnkvt{Sj³ BIvSnse 12þmw hIp¸pw 1999þse tIcf P\\þacW cPnkvt{Sj³ N«§fnse 8þmw
N«hpw A\pkcn¨v \ðIp¶Xv).
(Issued under Section 12 of the Registration of Births and Deaths Acts, 1969 and Rule 8 of the Kerala Registration of Births and Deaths
Rules, 1999)
Xmsg ]dbp¶ hnhc§Ä tIcf kwØm\¯nse FdWmIpfw Pnñbnse IWb¶pÀ Xmeq¡nse acSv ap\nkn¸menÁn
þse (Xt±iØm]\w) AÊð acW cPnÌdnð \n¶v FSp¯n«pÅhbmsW¶v km£ys¸Sp¯p¶p.
This is to certify that the following information has been taken from the original record of death which is the register for (local area/local
body) Maradu Municipality of Taluk Kanayannur of District Ernakulam of State Kerala.
---t]cv/ Name : sPan\n H.BÀ./ JEMINI.O.R.

---B¬/s]¬/ Sex : B¬/ Male


: 15/01/2007
acW XobXn/ Date of Death (FIFTEEN/ONE/TWO THOUSAND SEVEN)

acW Øew/ Place of Death : tet£mÀ tlmkv]näð & dnkÀ¨v skâÀ en., s\«qÀ/

Lakeshore Hospital & Research Center Ltd., Nettoor

---amXmhnsâ t]cv / Name of Mother : kpPmX (`mcy)/ SUJATHA.A.L. (Wife)


]nXmhnsâ t]cv/`À¯mhnsâ t]cv/ chn (]nXmhv)/ RAVI.O.G. (Father)
:
Name of Father/Husband
acn¨ hyànbpsS acWkabs¯ : *** e`yañ
taðhnemkw
Address of the deceased at the time of : ***Not Available
death
acn¨ hyànbpsS Øncamb Hmtfm¸nÅn, Xpdhp¦c ]n.H, ImªqÀ,, FdWmIpfw,682304
:
taðhnemkw
Permanent address of deceased : OLOPPILLI HOUSE, THURAVUMKARA.P.O., KANJOOR,
ERNAKULAM,682304

cPnkvt{Sj³ \¼À/ : 45/2007 cPnkvt{Sj³ XobXn/ : 19/01/2007


Registration Number Date of Registration
---A`n{]mb¡pdn¸v/ Remarks (if any) : *** AÊð tcJIfnð \nehnepÅ taðhnemks¯ kw_Ôn¨ tImf§Ä DÄs¸Sq¶nñ

*** The original records do not contain the column relating to present address

---\ðIp¶ XobXn/ Date of Issue : 02/07/2019 (18:16) Last Updated on 07/11/2014 (10:06)
\ðIp¶ A[nImcnbpsS taðhnemkw/ Registrar of Births and Deaths ,
:
Address of the issuing authority
Maradu Municipality

“Ensure Registration of Every birth and death”


“Hmtcm P\\hpw acWhpw cPnÌÀ sNbvXpsh¶v Dd¸phcp¯pI”
This certificate is computer generated and does not require any Seal/Signature in original.
The Govt. vide G.O.(Ms) No.202/2012/LSGD dated 25/07/2012 has approved this certificate as a valid document for all official purposes
Authenticity of this certificate can be verified at www.cr.lsgkerala.gov.in. The Key Number is unique to each event.
Software developed and supported by Information Kerala Mission.
Certificate printed before the last updated date is invalid
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