1

GOVERNMENT OF MAHARASHTRA

DEPARTMENT OF HEALTH

No. 1

-6
FORM-6

MUNICIPAL CORPORATION OF GREATER MUMBAI A
WARD

-
DEATH CERTIFICATE
, 1969 12/17 , 2000 8/13 .
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE MAHARASHTRA 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 MUNICIPAL CORPORATION OF GREATER MUMBAI A WARD OF TAHSIL/BLOCK GREATER MUMBAI OF DISTRICT MUMBAI OF STATE/UNION
TERRITORY MAHARASHTRA, INDIA.

/ NAME OF DECEASED : MR. SANJAY VIJAYNATH UPADHYAY

/ SEX: / MALE

/ DATE OF DEATH:
29-01-2016
TWENTY-NINTH-JANUARY-TWO THOUSAND SIXTEEN

/ PLACE OF DEATH:
BOMBAY HOSPITAL

/ AGE OF DECEASED:
45 YEARS

/ / NAME OF HUSBAND / WIFE:

/ / HUSBAND/WIFE UID NO. :
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/ NAME OF MOTHER:
MRS. VIDYADEVI

/ NAME OF FATHER :
MR. VIJAYNATH UPADHYAY

/ MOTHER'S UID NO. :

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/ FATHER'S UID NO. :

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/ ADDRESS OF THE DECEASED AT THE TIME OF / PERMANENT ADDRESS OF DECEASED

DEATH :
:
AUDUMBER APT., , A/206, SHANKAR PAWSHE RD.,
SAI BABA NAGAR, KATEMANIVALY, KALYAN-DOMBIVLI, KALYAN, THANE,
MAHARASHTRA- 421306
/ REGISTRATION NO:
D-2016: 27-90258-000012

AUDUMBER APT.,, A/206, SHANKAR PAWSHE RD.,

SAI BABA NAGAR, KATEMANIVALY, KALYAN-DOMBIVLIKALYAN,
THANE,
MAHARASHTRA- 421306
/ DATE OF REGISTRATION:
08-02-2016

/ REMARKS (IF ANY):

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/ DATE OF ISSUE:
01-04-2016

/ ISSUING AUTHORITY
- ( )
SUB-REGISTRAR (BIRTH & DEATH)

"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 DOUCMENT FOR ALL OFFICIAL PURPOSES.
THE AUTHENTICITY OF THIS CERTIFICATE CAN BE VERIFIED FROM THE WEBSITE CRSORGI.GOV.IN.
THE REGISTRATION NUMBER IS UNIQUE TO EACH EVENT.
" " / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "