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GOVERNMENT OF JHARKHAND
No. 1
-6
FORM-6
DEPARTMENT OF PLANNING AND DEVELOPMENT
JAMSHEDPUR NOTIFIED AREA COMMITTEE
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DEATH CERTIFICATE
( , 1969 12 / 17 , 2009 8/13 )
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE JHARKHAND REGISTRATION OF BIRTHS & DEATHS
RULES 2009.)
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/ ,
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER FOR JAMSHEDPUR
NOTIFIED AREA COMMITTEE OF TAHSIL/BLOCK GOLMURI-CUM-JUGSALAI OF DISTRICT PURBI SINGHBHUM OF STATE/UNION TERRITORY JHARKHAND, INDIA.
/ NAME OF DECEASED : RAJ KUMARI DEVI
/ SEX: / FEMALE
/ DATE OF DEATH:
12-09-2016
TWELFTH-SEPTEMBER-TWO THOUSAND SIXTEEN
/ PLACE OF DEATH:
TATA MAIN HOSPITAL
/ AGE OF DECEASED:
77 YEARS
/ / NAME OF HUSBAND / WIFE:
LATE M. P SINGH
/ / HUSBAND/WIFE UID NO. :
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/ NAME OF MOTHER:
/ NAME OF FATHER :
/ MOTHER'S UID NO. :
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/ FATHER'S UID NO. :
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/ ADDRESS OF THE DECEASED AT THE TIME OF DEATH : / PERMANENT ADDRESS OF DECEASED :
B-10,ROAD NO 6,RAJU BAGAN, WEST KITADIH,TATA NAGAR ,JSR,
JAMSHEDPUR (NAC), GOLMURI-CUM-JUGSALAI, PURBI SINGHBHUM,
JHARKHAND
JAMSHEDPUR (NAC)GOLMURI-CUM-JUGSALAI, PURBI SINGHBHUM,
JHARKHAND
/ REGISTRATION NO:
D-2016: 20-90019-003536
/ DATE OF REGISTRATION:
14-09-2016
/ REMARKS (IF ANY):
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/ DATE OF ISSUE:
14-09-2016
/ ISSUING AUTHORITY
( )
REGISTRAR (BIRTH & DEATH)
JAMSHEDPUR NOTIFIED AREA COMMITTEE
UPDATED ON :
2016-09-14
"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.
THE AUTHENTICITY OF THIS CERTIFICATE CAN BE VERIFIED FROM THE WEBSITE CRSORGI.GOV.IN.
THE REGISTRATION NUMBER IS UNIQUE TO EACH EVENT.
" " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "