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W*GG* DEATH CERTIFICATE TRANSCRIPTION FORM

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ORIGIN of CERTIFICATE - COUNTRY & / or STATE          

Please enter the details EXACTLY as they appear on the Certificate
REGISTRATION DISTRICT  
YEAR  
DEATH in the Sub-District of  
in the  
No.  
When and where died  
Name and Surname  
Sex  
Age  
Occupation  
Cause of Death  
Signature, description and residence of informant  
When registered  
Signature of registrar  

Other comments or information


Submitter's Name
Submitter's E-mail
Source of information

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© 2002  Vivian Egan This page was last modified
11 September 2003
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