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  • Surat Kematian

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    Widhi nugroho
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    This document is a death certificate from the village head of Bunut Village in Way Ratai Subdistrict, Pesawaran Regency. It certifies that Sukra, a farmer from Bunut Village, died on June 16, 2026 in Bunut Village and was buried in the Bunut village cemetery. Sukra was the husband of Salsa Desi Damayanti, born November 13, 2006, who is a student and lives in Bunut Village. The village head signed the certificate on November 3, 2023 to confirm these details.

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    Contoh surat kematian dari desa

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    This document is a death certificate from the village head of Bunut Village in Way Ratai Subdistrict, Pesawaran Regency. It certifies that Sukra, a farmer from Bunut Village, died on June 16, 2026 in Bunut Village and was buried in the Bunut village cemetery. Sukra was the husband of Salsa Desi Damayanti, born November 13, 2006, who is a student and lives in Bunut Village. The village head signed the certificate on November 3, 2023 to confirm these details.

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    © All Rights Reserved
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    8 views1 page

    Surat Kematian

    Uploaded by

    Widhi nugroho
    This document is a death certificate from the village head of Bunut Village in Way Ratai Subdistrict, Pesawaran Regency. It certifies that Sukra, a farmer from Bunut Village, died on June 16, 2026 in Bunut Village and was buried in the Bunut village cemetery. Sukra was the husband of Salsa Desi Damayanti, born November 13, 2006, who is a student and lives in Bunut Village. The village head signed the certificate on November 3, 2023 to confirm these details.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
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    PEMERINTAH KABUPATEN PESAWARAN

    KECAMATAN WAY RATAI


    DESA BUNUT
    Alamat : Jl. Raya Way Ratai Desa Bunut Kecamatan Way Ratai pesawaran 35451

    SURAT KETERANGAN KEMATIAN


    Nomor : / / / /

    Yang bertanda tangan dibawah ini Kepala Desa Bunut Kecamatan Way Ratai Kabupaten
    Pesawaran, menerangkan dengan sebenarnya bahwa :

    Nama : SUKRA

    Jenis Kelamin : LAKI - LAKI

    Tempat T/L : BUNUT, 07 – 10 – 1963

    Pekerjaan : PETANI

    Alamat : Dusun Bunut Tengah Rt. 002 / Rw. 002 Desa Bunut
    Kecamatan Way Ratai Kabupaten Pesawaran

    Bahwa benar nama tersebut diatas adalah warga Desa Bunut Kecamatan Way Ratai Kabupaten
    Pesawaran dan telah MENINGGAL dunia pada :

    Pada Hari : KAMIS

    Pada Tanggal : 16 – 06 - 2016

    Tempat : Dusun Bunut Tengah Rt. 002 / Rw. 002 Desa Bunut
    Kecamatan Way Ratai Kabupaten Pesawaran

    Dimakamkan : di TPU Desa bunut

    Dimana almarhum/ah diatas adalah SUAMI / ISTRI / ANAK / ORANG TUA dari :

    Nama : SALSA DESI DAMAYANTI

    Tempat T/L : 13 – 11 - 2006

    Pekerjaan : PELAJAR

    Alamat : Dusun Bunut Tengah Rt. 002 / Rw. 002 Desa Bunut
    Kecamatan Way Ratai Kabupaten Pesawaran

    Demikian Surat Keterangan Kematian ini dibuat dengan sebenarnya dan dapat dipergunakan
    sebagai mana mestinya agar yang berkepentingan harap maklum adanya.

    Bunut, 03 Nopember 2023


    Kepala Desa Bunut

    BAYU PISKA MAHENDRA

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