To
The District Registrar,
Births and Deaths,
District_________________.
Subject: - Request for Death Certificate
Sir,
Kindly issue me_________copies of death certificate as per particulars are given below:-
1. Date of Death ____________________________________
2. Full name of deceased ____________________________________
3. Sex (Male/female) ____________________________________
4. Place of Death ____________________________________
5. Full name of Father/husband ___________________________________
Of deceased
6. Permanent Address ____________________________________
7. Place of cremation ____________________________________
Thanking you,
Yours faithfully,
( )
Name_________________
Address________________
Total amount of Rs.______________
Receipt No._____________________ Dated__________________