Registration of Deaths Volume __________ Page __________ Date recorded __________________ Location -- =======================================================================================
1.Full name of Deceased --- 2. Age --- 3.Place of Death --- 4.Residence of Deceased --- 5. Marital Status -- 6. Name of Spouse -- 7. Name of Father of Dec. -- 8.Name of Mother of Dec.-- 9.Occupation - 10. Place of Birth - 11. Date of Birth - 12. Date of Death - 13. Cause of Death - 14 Place of Burial - 15. Informant & Address - 16. Date of Certificate - 17. Date of Registration - 18. Comments - - -
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