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    DIPANSHI DC

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    DIPANSHI DC

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    DIPANSHI DC

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    स◌ं˙.

    1
    NO. 1 GOVERNMENT OF UTTAR PRADESH
    DEPARTMENT OF MEDICAL AND HEALTH प -6
    FORM-6

    GRAMA PANCHAYAT BARJI

    DEATH CERTIFICATE
    (ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE
    UTTAR PRADESH REGISTRATION OF BIRTHS & DEATHS RULES 2002.THIS IS TO CERTIFY THAT THE FOLLOWING
    INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATHWHICH IS THE REGISTER FOR GRAMA
    PANCHAYAT BARJI OF TAHSIL/BLOCK SAGRI OF DISTRICT AZAMGARH OF STATE/UNION TERRITORY UTTAR
    PRADESH, INDIA.

    NAME OF DECEASED : DIPANSHI VERMA


    SEX: FEMALE

    DATE OF DEATH: PLACE OF DEATH:


    23-06-2023 LUCKNOW, UTTAR PRADESH.
    TWENTY THREE-JUNE-TWO THOUSAND
    TWENTY THREE
    NAME OF HUSBAND / WIFE:

    AGE OF DECEASED: 19 YEARS MR.AYUSH VERMA HASBAND’S ADHAR


    NO : 875201534744

    NAME OF MOTHER: NAME OF FATHER : MANISH VERMA


    DR. AMITA KANUJIYA MOTHER'S AADHAAR
    NO: 458812639025 FATHER'S AADHAAR NO:
    836596458012

    ADDRESS OF THE DECEASED AT PERMANENT ADDRESS OFDECEASED:


    THE TIME OF DEATH: KASHI RAM KASHI RAM AVAS COLONY GOLA,UTTAR
    AVAS COLONY GOLA,UTTAR
    PRADESH
    PRADESH
    REGISTRATION NO: DATE OF REGISTRATION:
    D-2023: 8-42809-000001 04-08-2023

    REMARKS (IF ANY):


    ---

    DATE OF ISSUE: ISSUING AUTHORITY


    19-08-2023
    REGISTRAR (BIRTH & DEATH)
    LUCKNOW UTTAR PRADESH

    UPDATED ON :
    11-08-2023 07:47:54

    "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 DOCUMENT FOR ALL OFFICIAL PURPOSES."
    " त◌्य'का ज◌ीन◌्म एव˙ं म<त्य¸ क◌ा' प˙ज◌ी;क◌ारण सं¸िच'िच@,त क◌ार8" / "ENSURE REGISTRATION OF EVERY BIRTH AND DEATH"

    ==

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