Application Acknowledgement
Dear Mrs. Nirmala Shaw,
Thank you for using West Bengal e-District 2.0 System.
Your application for Permission for Delayed Registration of Death under Government of West
Bengal has been successfully submitted.
Application Summary
AIN : 210502506400034236
Name of the Applicant : Mrs. Nirmala Shaw
Date of the Application : 02-Jul-2025
Address : HOUSE NO 5,GALI NO 16,MEGHNA MORE, Village/Ward:-
18, Post Office:- Jagatdal SO, Police Station:- Jagtadal, North
24 Parganas, West Bengal, India, Pincode:- 743125.
Special Notice : It is mandatory to bring this acknowledgement slip
to collect certificate.
For any query please contact your nearest Kiosk operator or the following contact details:
Municipality :- Bhatpara (Municipality)
Sub-Division :- Barrackpur
North 24 Parganas, West Bengal, India.
Generated From: https://edistrict.wb.gov.in/ Dated: 02-Jul-2025
Applicant Details
Salutation First Name Middle Name Last Name
Mrs. Nirmala NA Shaw
Date Of Birth Age Gender Date of Application
1-JANUARY-1969 56 Female 2-JULY-2025
Mobile Number Email Aadhaar
8617727119 shawsumit706@gmil.com 485462233524
Place Of Death
Country State District Sub Division
India West Bengal North 24 Parganas Barrackpur
Block/Municipality/Municipal Block/Municipality/Municipal
Rural or Urban Village Ward
Corporation Corporation Name
U 18
M Bhatpara (Municipality)
Address Line 1
.0
Police Station Post Office Address Line 2
HOUSE NO 5,GALI NO
Jagtadal Jagatdal SO NA
16,MEGHNA MORE
t2
Place Name
Pincode Birth Place Type
HOUSE NO 5,GALI NO
743125 Home
16,MEGHNA MORE
ic
Details Of Deceased
tr
Salutation First Name Middle Name Last Name
is
Mr. Chhedi NA Shaw
D
Date Of Death Gender Aadhaar Age
6-OCTOBER-2019 Male 741147564700 54
e-
Religion Occupation Relation With Applicant UID No
Hinduism Worker Wife 485462233524
Details Of Father
Same As Applicant Salutation First Name Middle Name
NO Mr. Shiunath NA
Last Name Aadhaar
Shaw NA
Details Of Mother
Same As Applicant Salutation First Name Middle Name
NO Mrs. Gangajali NA
Last Name Aadhaar
Devi NA
Details Of Spouse
Generated on : 2025-07-02T12:15:36.470
P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
Same As Applicant Salutation First Name Middle Name
YES Mrs. Nirmala NA
Last Name Aadhaar
Shaw 485462233524
Permanent Address Of Deceased
Same Address As Country State District
Place Of Death India West Bengal North 24 Parganas
Block/Municipality/Municipal Block/Municipality/Municipal
Sub Division Rural or Urban
Corporation Corporation Name
Barrackpur U
M Bhatpara (Municipality)
Address Line 1
Village Ward Police Station Post Office
HOUSE NO 5,GALI NO
18 Jagtadal Jagatdal SO
16,MEGHNA MORE
Address Line 2 Pincode
.0
NA 743125
Present Address
t2
Same Address As Country State District
ic
Place Of Death India West Bengal North 24 Parganas
Block/Municipality/Municipal Block/Municipality/Municipal
Sub Division Rural or Urban
tr
Corporation Corporation Name
Barrackpur U
M Bhatpara (Municipality)
is
Address Line 1
Village Ward Police Station Post Office
HOUSE NO 5,GALI NO
D
18 Jagtadal Jagatdal SO
16,MEGHNA MORE
e-
Place Name
Address Line 2 Pincode Birth Place Type
HOUSE NO 5,GALI NO
NA 743125 Home
16,MEGHNA MORE
Address of Deceased at the time of Death
Same Address As Country State District
Place Of Death India West Bengal North 24 Parganas
Block/Municipality/Municipal Block/Municipality/Municipal
Sub Division Rural or Urban
Corporation Corporation Name
Barrackpur U
M Bhatpara (Municipality)
Address Line 1
Village Ward Police Station Post Office
HOUSE NO 5,GALI NO
18 Jagtadal Jagatdal SO
16,MEGHNA MORE
Place Name
Address Line 2 Pincode Birth Place Type
HOUSE NO 5,GALI NO
NA 743125 Home
16,MEGHNA MORE
Details of 5 local Person granting okay to Delayed Registration
Generated on : 2025-07-02T12:15:36.516
P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
Address Of Person Two
Name Of Person One Address Of Person One Name Of Person Two HL/NO-08,BL/NO-17,
CHANDAN KUMAR DAS 14 BL NO 15 JAGATDAL RAM BABU SHAW MEGHANA MORE MAJDOOR
BHAWAN JAGATDAL
Address Of Person Three Address Of Person Four
Name Of Person Three Name Of Person Four
HOUSE NO 5, GALI NO 16, HOUSE NO 5, GALI NO 16,
ANUP KUMAR GOND VISHAL KUMAR SHAW
MEGHANA MORE MEGHANA
Address Of Person Five
Name Of Person Five
HOUSE NO 5, GALI NO 16,
OMPARKASH SHAW
MEGHANA
Other Details
In case this is a female death,
Name of Disease or Actual did the death occur while
Type of medical attention Was the cause of death
Cause of Death pregnant, at the time of
received before death medically certified?
Cardio Respiratory Failure in delivery or within 6 weeks after
.0
No medical attention YES
case of Bronchial Asthma the end of pregnancy
NO
If used to habitually chew
t2 If used to habitually chew
If used to habitually smoke - for arecanut in any form (including If used to habitually drink arecanut in any form (including
how many years pan masala) - for how many alcohol - for how many years? pan masala) - for how many
ic
NA years? NA years?
NA NA
tr
is
D
e-
Generated on : 2025-07-02T12:15:36.557
P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
