DEATH CERTIFICATE
मृत्यु प्रमाण-पत्र
(ISSUED UNDER SECTION 12/17 OF THE REGISTRATION OF BIRTHS & DEATHS ACT, 1969 AND 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 BIRTH WHICH IS THE REGISTER FOR FAKHRUDDIN ALI AHMED MEDICAL COLLEGE, BARPETAASSAM OF TAHSIL/BLOCK BARPETA OF DISTRICT BARPETA OF STATE/UNION TERRITORY ASSAM, INDIA.
NAME OF DECEASED/ मृतक का नाम : ANJU DEVI
SEX / लिंग : FEMALE
AADHAAR NUMBER / आधार नंबर:
XXXX-XXXX-7233
DATE OF DEATH / मृत्यु की तिथि :
25-01-2026
TWENTY-FIFTH-JANUARY-TWO THOUSAND TWENTY SIXTEEN
PLACE OF DEATH / मृत्यु का स्थान :
PRIMARY HEALTH CENTRE TILAUTHOO, THAUTHU, TILOUTHE ROHTAS, BIHAR
NAME OF HUSBAND / WIFE/ पति / पत्नी का नाम :
KAMLESH KUMAR
AGE OF DECEASED / मृतक की उम्र :
31 YEAR'S 9 MONTH'S
NAME OF MOTHER / माता का नाम :
SONAMUNI DEVI
NAME OF FATHER / पिता का नाम :
BUTAN CHAUDHARY
AADHAAR NUMBER OF MOTHER / आधार नंबर:
AADHAAR NUMBER OF FATHER / आधार नंबर:
ADDRESS OF THE DECEASED AT THE TIME OF DEATH /
मृत्यु के समय मृतक का पता:
RAMDIHIRA, HURKA, TILOUTHU, ROHTAS, BIHAR, 821312
PERMANENT ADDRESS OF DECEASED / मृतक का स्थायी पता:
RAMDIHIRA, HURKA, TILOUTHU, ROHTAS, BIHAR, 821312
REGISTRATION NUMBER / पंजीकरण संख्या:
D20250920971866610
DATE OF REGISTRATION / पंजीकरण तारीख :
25-01-2026
REMARKS (IF ANY) / टिप्पणी:
DATE OF ISSUE / जारी करने की तिथि:
04-04-2026
S.No.2
सं.1
GOVERNMENT OF ASSAM
असम सरकार
DEPARTMENT OF HEALTH AND FAMILY WELFARE
FAKHRUDDIN ALI AHMED MEDICAL COLLEGE, BARPETAASSAM
फखरुद्दीन अली अहमद मेडिकल कॉलेज, बारपेटा असम
FORM 6
प्रपत्र-6
Updated On: 04-04-2026 01:24:11
‘ThisQRcodecanbeusedtochecktheauthenticityofthe
certificate’
SIGNATURE OF ISSUING AUTHORITY / जारी करने वाला प्राधिकारी:
रजिस्ट्रार (जन्म एवं मृत्यु)
SUB-REGISTRAR (BIRTH & DEATH)
FAKHRUDDIN ALI AHMED MEDICAL COLLEGE, BARPETAASSAM
फखरुद्दीन अली अहमद मेडिकल कॉलेज, बारपेटा असम
SUB-REGISTRAR (BIRTH & DEATH)
FAKHRUDDIN ALI AHMED MEDICAL COLLEGE, BARPETAASSAM
फखरुद्दीन अली अहमद मेडिकल कॉलेज, बारपेटा असम
"ENSURE REGISTRATION OF EVERY BIRTH AND DEATH / प्रत्येक जन्म एवं मृत्यु का पंजीकरण सुनिश्चित करें"