FROM-6

GOVERNMENT OF ASSAM
DEPARTMENT OF HEALTH AND FAMILY WELFARE
URBAN PHC SILCHAR

DEATH CERTIFICATE

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT. 1969AND RULE 8/13 OF THE ASSAM
REGISTRATION OF BIRTHS & DEATHS RULES 1999)

THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS
THE REGISTER FOR URBAN PHC SILCHAR OF TAHSIL/BLOCK SONAI OF DISTRICT CACHAR OF STATE/UNION TERRITORYASSAM
INDIA.

NAME OF DECEASED : ANAMUL HOQUE CHOUDHURY SEX: MALE

DATE OF DEATH PLACE OF DEATH:

25-07-2023 BERENGA, BERENGA PT II, SILCHAR, CACHAR, ASSAM
TWENTYFIVE JUL TWO THOUSAND TWENTY THREE
NAME OF HUSBAND / WIFE:

AGE OF DECEASED:
45 YEARS HUSBAND /WIFE AADHAR NO:

NAME OF MOTHER: NAME OF FATHER:

KAMRUL ISLAM CHOUDHURY
MOTHER’S AADHAR NO: FATHER’S AADHAR NO:

ADDRESS OF THE DECEASED AT THE TIME OF DEATH : PERMANENT ADDRESS OF DECEASED:

BERENGA, BERENGA PT II, SILCHAR, CACHAR, BERENGA, BERENGA PT II, SILCHAR, CACHAR,
ASSAM ASSAM

REGISTRATION NO: DATE OF REGISRTAION:

D:2023: 18-91911-000182 22-09-2023

REMARKS (IF ANY)

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DATE OF ISSUE: ISSUING AUTHORITY

22-09-2023
REGISTRAR (BIRTH & DEATH)
URBAN PHC SILCHAR

UPDATED ON:
22-09-2023 12:06:05

“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”