‘uigeuib ereier 6 Form No. 6 SS siiippn® ae GOVERNMENT OF TAMIL NADU eumeumings gieosy DEPARTMENT OF REVENUE ADMINISTRATION Apsvoumis Momo expr NELVAI VILLAGE PANCHAYAT Quy eresnpsp / DEATH CERTIFICATE (Dept ogy Geocsry wpb ey oL.sb, 19696 Sfloy 12/17 wopbypied gous Dyes yisey apb ley ail Brenctr 2000 a6) over, 8/13 {Spisueb oe Buy use 1a 1217 DIO pABIHOM Spiny Hou Bley ap 6. |(SSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE TAMIL NADU REGISTRATION OF BIRTH JANO DEATH RULES 2000) Spocin. pod HdOHun, poipoO weld, qnowAiGucen wnetiid, aadoncemd aur, Apéiwumis Fgmo neem abiipe oie Bindu tiple eoSighp @Guaiut amar sen oncegy sheen oGaDe) [THis is To CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER FOR INELVAI VILLAGE PANCHAYAT OF ARAKKONAM TALUK OF RANIPET DISTRICT OF TAMIL NADU STATE, INDIA. NAME OF DECEASED / @npbysoutietr Qui SEX / upoBlerib: MALE / aeisr RAMU / map UID NUMBER OF DECEASED / mibyssufles sygmt orci DATE OF DEATH / @mibys Gayl: 29/01/2023 "TWENTY NINE JANUARY - TWO THOUSAND TWENTY THREE AGE OF DECEASED / @ppeutet auwgy: SA YEARS 119, gener Bomrasled Apes, Opetror dd, Cipdrouris 631081 NAME OF MOTHER /gunuSlebr Quad PAIMER NAME Benue Cus ors Uo MIMEER/ nnd gan ee FATHERS UO NO./ sheng card ast HUSBAND / WIFE NAME / mexsreug / wwenesta) Gaui ” ee CHITRA, é\gion HUSBAND / WIFE VO NO / mena / women ayer te ADDRESS OF THE DECEASED AT THE ME OF DEATH / PERMANENT ADDRESS OF DECEASED / muse Burgi apdoaie epeash Bpdpauid Suds aah 119, ouuANAL ROVE STREET, THENNAL, NELVONTHRUMALPUROST, 19, BAJANAIKOVL STREET THENNAL NELVOY,THIRUMALPUR POST, Evi, RAMEY TAME NADU SNOST eit RANIDE TAMIL NADL SOTO 119, uggenen Ganeed Ong Gipcnens.Opéinunis, 119, upgenen Gomreiéo Op, Apcnenss Aperninis, POW Us NTO, APN greahsduronc psiponG- MeOwswuyd saved, Opes grewALsdat anc, psiponG- frost at081 REGISTRATION NUMBER / pla acd DATE OF REGISTRATION /uplaj Qaip @iy6): 2101/2028 -2023:38-18205-000002 REMARKS (FF ANY) / wfhty Ben. why, DATE OF SUE /uypnuusgetr:21/00/2028 ISSUING AUTHORITY / omens ayefieu REGISTRAR (BIRTH & DEATH) uBlourrens (Spy & Guy) ren vesastreia cysiemu dno mennc Pa elec rtm Sra tear comer SA ES LES oo oa ST TTT OTT Dssooonpaarse721v9r20z3