[Boutique] hospital death certificate

Part 1: Hospital death certificate

__________ Due to going to __________ country __________, you need to apply for __________ death notary. After investigation of the personnel file or according to _______________________, I hereby certify: _____________, _____ male, born on ________________________________________________________________

, in the province of __________________________

The city died.

Hereby prove

Fill in the person: ____________

Sealed by relevant departments:

Article 2: Hospital death certificate

Normal death certificate

Dead name, gender, date of birth

Home address

employer

Time of death

Place of death

Spouse name gender date of birth

cause of death:

Issuer:

contact number:

year month day

Issuing unit

year month day