D.P.H. – 368 Form No.
10
(See Rule 9)
DEATH CERTIFICATE
Chief Registrar (Birth & Death)
Punjab, Chandigarh
It is certified that the Information written below has been taken from the original Birth Record
which is registered in the Register of Local Registrar Birth & Death MUNICIPAL
COMMITTEE, LUDHIANA, Tehsil LUDHIANA District LUDHIANA State Punjab.
Name : Sukhdev Singh Permanent Address : H no. 246-A Model town extension
Ludhiana (Pb)
Father’s Name : Chanan Singh
Nationality : Indian
Sex : Male
Date of Death : 09/01/2024 Registration No. : 67
Place of Death : Ludhiana Date of Registration : 13/02/2024
Certificate preparing person’s Signature Certificate issuing person’s Signature
Name : Kulwant
Name : Jaswant Singh Stamp
Local Registrar, Birth & Death
Municipal Committee, Ludhiana
Date : 19/02/24
Note :- This Certificate (Death) has been issued under the Birth & Death Registration Act 1969
(India Govt.) Section 12/17. What cause of death has been told in the Death register, That
information will not be given in the Death Certificate