20. Duration of pregnancy (in weeks)............................................

(To be filled by the Registrar)
(To be filled by the Registrar)
Name
Code No.
District................................................................................................
................................................
Tehsil..................................................................................................
................................................
Town Village.......................................................................................
................................................
Registration Unit............................................................................
................................................
Registration No..............................................................................
Registration date...................
Date of birth.................................................................................
Name and Signature of the Registrar and Seal
Death Report Form
Death Report Form
( See Rule 5)
Form No. 2
Form No. 2
Death Report Form
Death Report Form
(Legal information)
(To be filled by the informant)
(To be filled by the informant)