居民死亡医学证明翻译英文模板

Resident’s death medical certificate (inference)

Name of the deceased：

Gender:

male

Ethnic ：

Han

Country：

China

Age：

Seal of medical and health institution

Sealed:

Dazhuang Central Hospital of Yinan County

Date

ID Type：ID Card

ID No.：

permanent address：

DOB：Aug.10.1938

Date of death: Feb.14.2021

Place of death:

At home

Cause of death:

Cor Pulmonale

Family members name:

Tel:

Police station opinions (seal)

Date

Family members address:

Signature of physician :

Signature of Police :

Administrative Code：300071321 No.：□□□□□□□□□□□□□

Note: 1. the family members of the deceased shall go to the public security organs for the cancellation of household registration procedures with this page 2. Without the signature of the physician and the police, the seal of the medical and health institution and the police station is invalid.

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