Department of Civil Registration & Census

Information of the Deceased. Please check the Details

CID/SR No.:

????:

First Name:

Middle Name:

Last Name:

Sex:

Date of Birth (DD/MM/YYYY):

Household No:

House No:

Dzongkhag:

Gewog:

Village:

Marital Status:

Occupation:

Mention particulars Information of the Deceased.

Date of Death:

Time of Death:

Cause of Death:

Mention particulars place of the Deceased.

Country:

Place of Death: Hospital BHU Home Other

Dzongkhag:

Gewog:

Village:

Present Death Address:

Attach Death Certificate issued by Hospital

Father's Detail of the Deceased.

CID/SR No.:

????:

First Name:

Middle Name:

Last Name:

Mother's Detail of the Deceased.

CID/SR No.:

????:

First Name:

Middle Name:

Last Name:

Mention person who last Attended the Deceased.

Doctor Health Worker Faith Healers Family Members Other

Mention Requestor's Detail of the Deceased.

CID/SR No.:

????:

Relation to Deceased:

First Name:

Middle Name:

Last Name:

I (Requestor) hereby declare that all the information provided herein is true and correct to the best of my knowledge. If proven to be false, I shall be liable for punishment as per the Law of the Land.

Government to Citizen Service Delivery Initiative