Panchayat:Repo18/vol2-page0403: Difference between revisions
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== | <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" | |||
|- | |- | ||
| 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 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 | ||
|| | || | ||
|- | |- | ||
| 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> |
Latest revision as of 12:36, 23 January 2019
Death Report Legal Information This part to be added to the
Death Register |
Death Report Statistical Information This part to be detached and sent for statistical processing |
|
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) |
To be filled by 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: |
To be filled by the informant 1. Institutional |
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 |
ഈ താൾ 2018 -ലെ പഞ്ചായത്ത് റെപ്പോ നിർമ്മാണം യജ്ഞത്തിന്റെ ഭാഗമായി സൃഷ്ടിച്ചതാണ്. |