D4798979478/2015

Zone

05

Division

059

Name

BOOPALAN

Name of Father / Husband

R. GOVINDASAMI

Name of Mother

Permanent Residential Address

NO:2/43, GANDHI NAGAR, 1ST STREET, KARUNEELAM,

SINGAPERUMAL KOIL VIA, KANCHIPURAM 603204

Address of the deceased at the

time of death

NO:2/43, GANDHI NAGAR, 1ST STREET, KARUNEELAM,

SINGAPERUMAL KOIL VIA, KANCHIPURAM 603204

Sex

Male

Age

52 YEARS

Date of Death

24-APR-2015

Place of Death

RAJIV GANDHI GOVERNMENT GENERAL HOSPITAL E.V.R.

ROAD CHENNAI -600003

Registration Number

2015/05/059/002916/0

Date of Registration

09-MAY-2015

Date of Issue
Remarks (If Any)

16-AUG-2015

16-AUG-2015

Note : This certificate is computer generated and does not require any Seal/Signature in original.
The authenticity of this certificate can be verified at www.chennaicorporation.gov.in. The Registration
Number is unique to each death.