सं.

1
No. 1
झारखंड सरकार प-6
GOVERNMENT OF JHARKHAND FORM-6
योजना एवं वकास वभाग (अथ एवं सांियक नदेशालय)
DEPARTMENT OF ECONOMICS & STATISTICS
नगर नगम , हज़ारबाग
NAGAR NIGAM, HAZARIBAG

मृयु माण-प
DEATH CERTIFICATE

(जम मृयु रिजकरण अधनयम , 1969 क धारा 12 / 17 तथा झारखंड जम मृयु रिजकरण नयम, 2009 के नयम 8/13 के अंतगत जार कया गया )

(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND RULE 8/13 OF THE JHARKHAND REGISTRATION OF BIRTHS &
DEATHS RULES 2009.)

यह मािणत कया जाता है ननलिखत सूचना मृयु के मूल अभलेख से ल गई है जो क नगर नगम , हज़ारबाग तहसील हजारबाग िजला हजारबाग राय/संघ देश
झारखंड,भारत के रिजटर म उिलिखत है ।
THIS IS TO CERTIFY THAT THE FOLLOWING INFORMATION HAS BEEN TAKEN FROM THE ORIGINAL RECORD OF DEATH WHICH IS THE REGISTER FOR NAGAR
NIGAM, HAZARIBAG OF TAHSIL/BLOCK HAZARIBAG OF DISTRICT HAZARIBAGH OF STATE/UNION TERRITORY JHARKHAND, INDIA.

मृतक का नाम / NAME OF DECEASED : SHREEBHAGAT KISAN लंग / SEX: पुरष / MALE

आधार नंबर / AADHAAR NO.:

XXXXXXXX0484

मृयु क तथ / DATE OF DEATH: मृयु का थान / PLACE OF DEATH:

05-02-2024 KISAN HOUSE DIPUGARHA , HAZARIBAG (NAGAR NIGAM), HAZARIBAG,
FIFTH-FEBRUARY-TWO THOUSAND TWENTY FOUR HAZARIBAGH, JHARKHAND.

पत / पी का नाम / NAME OF HUSBAND / WIFE:

मृतक क उ / AGE OF DECEASED: PARWATI DEVI
86 YEARS
आधार नंबर / HUSBAND/WIFE AADHAAR NO. :

माता का नाम / NAME OF MOTHER: पता का नाम / NAME OF FATHER :

LATE JALESHWARI DEVI LATE NIRSU BHAGAT

आधार नंबर / MOTHER'S AADHAAR NO. :

--- आधार नंबर / FATHER'S AADHAAR NO. :
---

मृयु के समय मृतक का पता / ADDRESS OF THE DECEASED AT THE TIME OF DEATH : मृतक का थायी पता / PERMANENT ADDRESS OF DECEASED :

KISAN HOUSE DIPUGARHA NEAR HOLY CROSS CONVENT , KISAN HOUSE DIPUGARHA NEAR HOLY CROSS CONVENT,
HAZARIBAG (NAGAR NIGAM), HAZARIBAG, HAZARIBAGH, HAZARIBAG (NAGAR NIGAM), HAZARIBAG, HAZARIBAGH,
JHARKHAND JHARKHAND

पंजीकरण संया / REGISTRATION NO: पंजीकरण तारख / DATE OF REGISTRATION:

D-2024: 20-90026-000195 26-02-2024

टपणी / REMARKS (IF ANY):

---

जार करने क तथ / DATE OF ISSUE: जार करने वाला ाधकार / ISSUING AUTHORITY
02-03-2024
रिजार (जम एवं मृयु)
REGISTRAR (BIRTH & DEATH)
NAGAR NIGAM, HAZARIBAG
नगर नगम , हज़ारबाग

UPDATED ON :
2024-02-26 06:17:01

"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.

" येक जम एवं मृयु का पंजीकरण सुनचत कर" / ENSURE REGISTRATION OF EVERY BIRTH AND DEATH "