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 : MOHASIN SEKH SEX : MALE
DATE OF DEATH : 19/04/2024 PLACE OF DEATH : ,BISHNUPUR - II, SOUTH 24 PARGANAS,
CHANDI, CHANDI, WEST BENGAL -
743503
AGE OF DECEASED : 54 YEARS NAME OF SPOUSE : NABIUNNESHA BIBI
SPOUSE IDENTITY PROOF. : AADHAAR-
XXXXXXXX4563
NAME OF MOTHER : NAME OF FATHER : MUKTAR ALI SK
MOTHER'S IDENTITY PROOF : - FATHER'S IDENTITY PROOF : -
ADDRESS OF THE DECEASED AT LOCALITY:-P.O-CHANDI, VILLAGE/TOWN:- CHANDI,BISHNUPUR - II,DIST:- SOUTH 24
THE TIME OF DEATH : PARGANAS,WEST BENGAL-743503
PERMANENT ADDRESS OF LOCALITY:-P.O-CHANDI, VILLAGE/TOWN:- CHANDI, BISHNUPUR - II,DIST:- SOUTH 24
DECEASED : PARGANAS,WEST BENGAL-743503
CERTIFICATE NO : D/2024/0255815 DATE OF REGISTRATION : 30/04/2024
-
REMARKS (IF ANY) :
DATE OF ISSUE : 30/04/2024 ISSUING AUTHORITY :
UPDATED ON : 2024-04-26 16:27:56
Signature Not Verified
Digitally Signed.
Name: Suvra Ghosh
Date: 30-Apr-2024 16:39:12
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