Panchayat:Repo18/vol2-page0403 - Revision history

Ratheeshthankappan at 12:36, 23 January 2019

2019-01-23T12:36:18Z

← Older revision		Revision as of 12:36, 23 January 2019
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	==== ''FORM - 2''' ====		<div class="center" style="width: auto; margin-left: auto; margin-right: auto;">''FORM - 2''</div>
			<div class="center" style="width: auto; margin-left: auto; margin-right: auto;">[see Rule No 5]</div>
			<div class="center" style="width: auto; margin-left: auto; margin-right: auto;">'''DEATH REPORT FORM'''</div>
			{\| class="wikitable"

	~~{\| class="wikitable"~~
	\|-
	~~! !! 'FORM - 2 [see Rule No5] !!~~
	\|-		\|-
	\| '''Death Report''' ~~Legal Information~~ This part to be added to the		\| '''Death Report Legal Information''' This part to be added to the
	Death Register		Death Register
	\|\| ~~'''DEATH REPORT FORM'''~~		\|\|Death Report Statistical Information <br>This part to be detached and sent for
	Death Report
	Statistical Information This part to be detached and sent for
	statistical processing		statistical processing
	\|\|		\|\|

LejiM at 07:21, 2 February 2018

2018-02-02T07:21:23Z

← Older revision		Revision as of 07:21, 2 February 2018
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	! !! 'FORM - 2 [see Rule No5] !!		! !! 'FORM - 2 [see Rule No5] !!
	\|-		\|-
	\| Death Report Legal Information This part to be added to the		\| '''Death Report''' Legal Information This part to be added to the
	Death Register		Death Register
	\|\| DEATH REPORT FORM		\|\| '''DEATH REPORT FORM'''
	Death Report		Death Report
	Statistical Information This part to be detached and sent for		Statistical Information This part to be detached and sent for

LejiM at 07:18, 2 February 2018

2018-02-02T07:18:35Z

← Older revision		Revision as of 07:18, 2 February 2018
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	\|\|		\|\|
	\|-		\|-
	\| To be filled by the informant 1.		\| To be filled by the informant <br>
	Date of Death: (Enter the exact day, month and year the death took place e.g.1-1-2000) <br>		1.Date of Death: (Enter the exact day, month and year the death took place e.g.1-1-2000) <br>
	Name of the deceased: (Full name as usually written) <br>		Name of the deceased: (Full name as usually written) <br>
	(a) Permanent address of the deceased: <br>		(a) Permanent address of the deceased: <br>

LejiM at 07:17, 2 February 2018

2018-02-02T07:17:54Z

← Older revision		Revision as of 07:17, 2 February 2018
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	~~THE REGISTRATION OF BIRTHS & DEATHS RULES, 1999~~


	==== ''FORM - 2''' ====		==== ''FORM - 2''' ====

	{\| class="wikitable"		{\| class="wikitable"
	\|-		\|-
	! ~~തലക്കുറി എഴുത്ത്~~ !! 'FORM - 2 [see Rule No5] !! ~~തലക്കുറി എഴുത്ത്~~		! !! 'FORM - 2 [see Rule No5] !!
	\|-		\|-
	\| Death Report Legal Information This part to be added to the		\| Death Report Legal Information This part to be added to the
Line 16:		Line 11:
	Statistical Information This part to be detached and sent for		Statistical Information This part to be detached and sent for
	statistical processing		statistical processing
	\|\| ~~കളത്തിലെ എഴുത്ത്~~		\|\|
	\|-		\|-
	\| To be filled by the informant 1.		\| To be filled by the informant 1.
	Date of Death: (Enter the exact day, month and year the death took place e.g.1-1-2000) Name of the deceased: (Full name as usually written) (a) Permanent address of the deceased: (b) Name of the father/husband: *[(C) Name of mother (d) Address of the deceased at the time		Date of Death: (Enter the exact day, month and year the death took place e.g.1-1-2000) <br>
	of the death.] Sex of the deceased: (Enter 'Male' or “Female': do not use abbreviation) Age of the deceased (If the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 year of age, give age in months, and if below 1 month give age in completed number of days, and if below one day, in hours.) Place of death: (Tick the appropriate entry 1, 2 or 3 below and give the name of the Hospital/ Institution or the address of the house where the death took-place). If other place, give location 1. Hospital institution Name: 2. House: Address: 3. Other Place: Informant's name: 1. Address:		Name of the deceased: (Full name as usually written) <br>
	~~\|\| To be filled by the informant~~ 2. Counter signature and seal of the		(a) Permanent address of the deceased: <br>
			(b) Name of the father/husband: *[(C) Name of mother <br>
			(d) Address of the deceased at the time
			of the death.] Sex of the deceased: (Enter 'Male' or “Female': do not use abbreviation) Age of the deceased (If the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 year of age, give age in months, and if below 1 month give age in completed number of days, and if below one day, in hours.) <br>
			Place of death: (Tick the appropriate entry 1, 2 or 3 below and give the name of the Hospital/ Institution or the address of the house where the death took-place). If other place, give location <br>
			1. Hospital institution Name: <br>
			2. House: Address: 3. Other Place: <br>
			Informant's name: <br>
			1. Address:<br>
			2. Counter signature and seal of the
	authorities concerned (in the case of		authorities concerned (in the case of
	hospitals/institutions) (After completing all columns 1 to 17 ~~informan~~ will put date and signature here:) ~~Dateurs~~ Signature or left thumb		hospitals/institutions) (After completing all columns 1 to 17 informant will put date and signature here:) Date <br>
	mark of the informant 7. Town or Village of Residence of the		Signature or left thumb mark of the informant <br>
			\|\| To be filled by the informant <br>

			7. Town or Village of Residence of the
	deceased: (Place where the deceased actually lived. This can be different from the place where the death occured. The house address is not required to be entered.) (a) Name of Town/Village: (b) Is it a town of village: (Tick the appro priate entry below)		deceased: (Place where the deceased actually lived. This can be different from the place where the death occured. The house address is not required to be entered.) (a) Name of Town/Village: (b) Is it a town of village: (Tick the appro priate entry below)
	1. Town: 2. Village: (C) Name of District: (d) Name of State: Religion (Tick the appropriate entry below 1. Hindu 2. Muslim 3. Christian 4. Any other religion		1. Town: <br>
	(write name of the religion) 9. Occupation of the deceased:		2. Village: <br>
	(If no occupation write 'Nil') 10. Type of the Medical attention received		(C) Name of District: (<br>
			d) Name of State: <br>
			Religion <br>
			(Tick the appropriate entry below 1. Hindu 2. Muslim 3. Christian 4. Any other religion
			(write name of the religion) <br>
			9. Occupation of the deceased:
			(If no occupation write 'Nil') <br>
			10. Type of the Medical attention received
	before death (Tick the appropriate entry below)		before death (Tick the appropriate entry below)
	\|\| To be filled by the informant 1. Institutional 2. Medical attention other than institution		\|\| To be filled by the informant <br>
			1. Institutional <br>
			2. Medical attention other than institution<br>
	3. No medical attention 11. Was the cause of death medically		3. No medical attention 11. Was the cause of death medically
	certified? (Tick the appropriate entry below) 1. Yes		certified? (Tick the appropriate entry below) 1. Yes
	2. No 12. Name of Disease or Actual Cause of		2. No <br>
			12. Name of Disease or Actual Cause of
	Death: (For all deaths irrespective of		Death: (For all deaths irrespective of
	whether medically certified or not) 13. In case this is a female death, did the		whether medically certified or not) <br>
			13. In case this is a female death, did the
	Death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy (Tick the appropriate entry below) 1. Yes		Death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy (Tick the appropriate entry below) 1. Yes
	2. No 14. If used to habitually smoke for how many		2. No <br>
	years? 15. If used to habitually chew tobacco in any		14. If used to habitually smoke for how many
	form - for how many years? 16. If used to habitually chew arecanut in any form (including pan masala) - for how many years? 17. If used habitually drink alcohol - for how many years? (Columns to be filled are over, Now put signature at left)		years? <br>
			15. If used to habitually chew tobacco in any
			form - for how many years? <br>
			16. If used to habitually chew arecanut in any form (including pan masala) - for how many years? <br>
			17. If used habitually drink alcohol - for how many years? (Columns to be filled are over, Now put signature at left)

	\|-		\|-

LejiM at 07:04, 2 February 2018

2018-02-02T07:04:08Z

← Older revision		Revision as of 07:04, 2 February 2018
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	~~403~~


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	''FORM - 2'''		==== ''FORM - 2''' ====

			{\| class="wikitable"
			\|-
			! തലക്കുറി എഴുത്ത് !! 'FORM - 2 [see Rule No5] !! തലക്കുറി എഴുത്ത്
			\|-
			\| Death Report Legal Information This part to be added to the
			Death Register
			\|\| DEATH REPORT FORM
			Death Report
			Statistical Information This part to be detached and sent for
			statistical processing
			\|\| കളത്തിലെ എഴുത്ത്
			\|-
			\| To be filled by the informant 1.
			Date of Death: (Enter the exact day, month and year the death took place e.g.1-1-2000) Name of the deceased: (Full name as usually written) (a) Permanent address of the deceased: (b) Name of the father/husband: *[(C) Name of mother (d) Address of the deceased at the time
			of the death.] Sex of the deceased: (Enter 'Male' or “Female': do not use abbreviation) Age of the deceased (If the deceased was over 1 year of age, give age in completed years. If the deceased was below 1 year of age, give age in months, and if below 1 month give age in completed number of days, and if below one day, in hours.) Place of death: (Tick the appropriate entry 1, 2 or 3 below and give the name of the Hospital/ Institution or the address of the house where the death took-place). If other place, give location 1. Hospital institution Name: 2. House: Address: 3. Other Place: Informant's name: 1. Address:
			\|\| To be filled by the informant 2. Counter signature and seal of the
			authorities concerned (in the case of
			hospitals/institutions) (After completing all columns 1 to 17 informan will put date and signature here:) Dateurs Signature or left thumb
			mark of the informant 7. Town or Village of Residence of the
			deceased: (Place where the deceased actually lived. This can be different from the place where the death occured. The house address is not required to be entered.) (a) Name of Town/Village: (b) Is it a town of village: (Tick the appro priate entry below)
			1. Town: 2. Village: (C) Name of District: (d) Name of State: Religion (Tick the appropriate entry below 1. Hindu 2. Muslim 3. Christian 4. Any other religion
			(write name of the religion) 9. Occupation of the deceased:
			(If no occupation write 'Nil') 10. Type of the Medical attention received
			before death (Tick the appropriate entry below)
			\|\| To be filled by the informant 1. Institutional 2. Medical attention other than institution
			3. No medical attention 11. Was the cause of death medically
			certified? (Tick the appropriate entry below) 1. Yes
			2. No 12. Name of Disease or Actual Cause of
			Death: (For all deaths irrespective of
			whether medically certified or not) 13. In case this is a female death, did the
			Death occur while pregnant, at the time of delivery or within 6 weeks after the end of pregnancy (Tick the appropriate entry below) 1. Yes
			2. No 14. If used to habitually smoke for how many
			years? 15. If used to habitually chew tobacco in any
			form - for how many years? 16. If used to habitually chew arecanut in any form (including pan masala) - for how many years? 17. If used habitually drink alcohol - for how many years? (Columns to be filled are over, Now put signature at left)

			\|-
			\| To be filled by the Registrar Registration No: Registration Date: Registration Unit: Town/Village
			District: Remarks: (if any)
			Name and Signature of the Registrar
			\|\| To be filled by the Registrar Name
			Code No. District: Tahsil: Town/Village: Registration Unit: Registration No.:
			Registration Date:
			\|\| To be filled by the Registrar Date of Death: Sex: 1. Male
			2. Female Age:
			Years/Months/Days/Hours Place of Birth: 1. Hospital/Institution
			2. House 3. Other Place Name and Signature of the Registrar

			\|}
	{{create}}		{{create}}

Vinod: '403 THE REGISTRATION OF BIRTHS & DEATHS RULES, 1999 ''FORM - 2''' {{create}}' താൾ സൃഷ്ടിച്ചിരിക്കുന്നു

2018-01-05T06:06:16Z

'403 THE REGISTRATION OF BIRTHS & DEATHS RULES, 1999 ''FORM - 2''' {{create}}' താൾ സൃഷ്ടിച്ചിരിക്കുന്നു

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403

THE REGISTRATION OF BIRTHS & DEATHS RULES, 1999

''FORM - 2'''
{{create}}