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265 (ftf. ^ ) (Fin. R. Form N>. ^ ^ ^^3 me. ^ ORIGINAL COPY ( NOT TRANSFERABLE J st?t!n^ ^-?f«receipt FOR PAYMENT TO GOVpRNffENT > % fe^ft/piace. v C V A ^ ^ ^ i r i ^ O a t c. \ > \. ;. ncm ct\cu Troir;. ^^^S>Vy’ \^CX \ V ^. 5-/R S-. ; on account o f. ^. C.. t V ^ ^ \ L M a ^ l («^/S ig n a tu re y j j j ^ Cashier or Accountant i\/< H>269 (P3TR>/ C ertificate No Form” 5 3TITO? GOVERNMENT OF MAHARASHTRA HEALTH DEPARTMENT 3I?I5I^umf?ra)T MUNICIPAL CORPORATION OF GREATER MUMBAI 3Jr^ WOTWSr DEATH CERTIFICATE ( 3? ^ ^ cl 3 J F 5? ^ / t l 3 3 T T f^ 3 ^ T t ^ ^ o o o i f f^tjmch-i 3T ^ ancr arr^,) (Issued under section 12/1? of the Registration of Births & Deaths Act, 1969 and Rule 8/13 of the Maharashtra Registration of Births and Deaths Rules, 2000.) 3?Tt: tsr, arrcft arf^:, ^ Ward 3 ^ ^ 3Tl r This is to certify that the following information has been taken from the original record of death which is the register for Municipal Corporation of Greater Mumbai of Ward L of D istrict Miiinbai of Maharashtra State. JTRT/ Full Name of Deceased : MR. RAJU D, GAIPCWAD Date of Death : n^ srm/ Name of Mother 3TO EZTcRfrcir Not Available, IHT/ Address of deceased at the time of death EKTA CO-OP HOUSING, SOCIETY, R.331,NEHRU NAGAR,, KURAL (E), MUMBAI, , Maharashtra,India. fpfrz Sex : Male fectw/ Place of Death : MUMBAI Name of Father/ Husband : MR. DADA R, GAIKWAD cjtekfryr zpnmw ttrti/ Permanant Address of deceased : EKTA CO-OP HOUSING,SOCIETY, R.331,NEHRU NAGAR,, KURAL (E), MUMBAI, , Maharashtra,India.?t7T/ Remarks (if any) : tcj^ir^/»/rc V^-,’ Dafe of Issje : > f$mw/ Sea. f^dicb/ Date of Registration : fm te a r t e r – ^ r i T f r Signature of the Issuing Authority grf?m-zntjr ^m/ Address of the issuing authority : WardL,Mumbai. c i t y o f t h i s c e r t i f i c a t e r^llst bfe v e r i f i e d fro m o u r w e b s it e h t t p. //p o i. L-vi ‘”crcrm q o i
