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Death Certi

This document is a death certificate for Sanjay Sharma from Grama Panchayat Kalinda Matyana in Himachal Pradesh, India. It provides details such as the date and location of death, age at death, names of parents, addresses, and registration information. The certificate confirms that the information was taken from the original death record registered in Kalinda Matyana.

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vasuvashisht034
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5K views1 page

Death Certi

This document is a death certificate for Sanjay Sharma from Grama Panchayat Kalinda Matyana in Himachal Pradesh, India. It provides details such as the date and location of death, age at death, names of parents, addresses, and registration information. The certificate confirms that the information was taken from the original death record registered in Kalinda Matyana.

Uploaded by

vasuvashisht034
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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सं.

1
No. 1
हमाचल देश सरकार प-6
GOVERNMENT OF HIMACHAL PRADESH FORM-6
वाय सेवाएं और परवार कयाण वभाग
DEPARTMENT OF HEALTH SERVICES AND FAMILY WELFARE
ाम पंचायत कलंदा मयना
GRAMA PANCHAYAT KALINDA MATYANA

मृयु माण-प
DEATH CERTIFICATE

(जम मृयु रिजकरण अधनयम , 1969 क धारा 12 / 17 तथा हमाचल देश जम मृयु रिजकरण नयम, 2003 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 HIMACHAL PRADESH REGISTRATION OF BIRTHS
& DEATHS RULES 2003.)

यह मािणत कया जाता है ननलिखत सूचना मृयु के मूल अभलेख से ल गई है जो क ाम पंचायत कलंदा मयना तहसील ठयोग िजला शमला राय/संघ देश
हमाचल 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 KALINDA MATYANA OF TAHSIL/BLOCK THEOG OF DISTRICT SHIMLA OF STATE/UNION TERRITORY HIMACHAL PRADESH, INDIA.

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

आधार नंबर / AADHAAR NO.:


XXXXXXXX6968

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


22-11-2021 KALINDA , MATIANA, KALEENDA, THEOG, SHIMLA, HIMACHAL PRADESH,
TWENTY-SECOND-NOVEMBER-TWO THOUSAND TWENTY ONE 171212.

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


मृतक क उ / AGE OF DECEASED:
51 YEARS
आधार नंबर / HUSBAND/WIFE AADHAAR NO. :
---

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


LT. GURDAS SHARMA

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 DEATH : मृतक का थायी पता / PERMANENT ADDRESS OF DECEASED :

KALINDA, KALINDA,
MATIANA, KALEENDA, THEOG, SHIMLA, MATIANA, KALEENDA, THEOG, SHIMLA,
HIMACHAL PRADESH- 171212 HIMACHAL PRADESH- 171212

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


D-2021: 2-02965-000003 14-12-2021

टपणी / REMARKS (IF ANY):


---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY
14-12-2021
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
GRAMA PANCHAYAT KALINDA MATYANA
ाम पंचायत कलंदा मयना

UPDATED ON :
2021-12-14 13:19:39

"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.

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

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