SignedDeathCertificate 3836295 671

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Form-6

GOVERNMENT OF WEST BENGAL


DEPARTMENT OF HEALTH AND FAMILY WELFARE

GRAM PANCHAYAT CHANDI

DEATH CERTIFICATE

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE WEST BENGAL
REGISTRATION OF BIRTHS & DEATHS RULES 2000.)

THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS
THE REGISTER FOR GRAM PANCHAYAT CHANDI OF BLOCK/MUNICIPALITY BISHNUPUR - II OF DISTRICT SOUTH 24 PARGANAS OF
STATE WEST BENGAL, INDIA.

NAME OF DECEASED : RAMISHA BIBI SEX : FEMALE

DATE OF DEATH : 26/04/2024 PLACE OF DEATH : ROSE LAND NURSING HOME,


BISHNUPUR - II, SOUTH 24 PARGANAS,
CHANDI, WEST BENGAL

AGE OF DECEASED : 84 YEARS NAME OF SPOUSE : ABUL KASEM MISTRY

SPOUSE IDENTITY PROOF. : AADHAAR-


XXXXXXXX1730

NAME OF MOTHER : NAME OF FATHER :

MOTHER'S IDENTITY PROOF : - FATHER'S IDENTITY PROOF : -

ADDRESS OF THE DECEASED AT LOCALITY:-P.O-MESTAKHALI, VILLAGE/TOWN:- MESTAKHALI,BISHNUPUR - I,DIST:- SOUTH 24


THE TIME OF DEATH : PARGANAS,WEST BENGAL-743503

PERMANENT ADDRESS OF LOCALITY:-P.O-MESTAKHALI, VILLAGE/TOWN:- MESTAKHALI, BISHNUPUR - I,DIST:- SOUTH 24


DECEASED : PARGANAS,WEST BENGAL-743503

CERTIFICATE NO : D/2024/0268645 DATE OF REGISTRATION : 09/05/2024


-

REMARKS (IF ANY) :

DATE OF ISSUE : 09/05/2024 ISSUING AUTHORITY :

UPDATED ON : 2024-05-03 12:38:45

Signature Not Verified


Digitally Signed.
Name: Suvra Ghosh
Date: 09-May-2024 12:26:20

SUB-REGISTRAR (BIRTH & DEATH)


GRAM PANCHAYAT CHANDI

"THIS IS A COMPUTER GENERATED CERTIFICATE."


THE GOVT.OF INDIA VIDE CIRCULAR NO. 1 / 12 / 2014 - VS(CRS) DATED 27 - JULY - 2015
HAS APPROVED THIS CERTIFICATE AS A VALID LEGAL DOCUMENT FOR ALL OFFICIAL PURPOSES

"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH"

The QR Code and Certificate Number can be verified through the portal https://janma-mrityutathya.wb.gov.in

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