FormNo:23H No.: To The Chief Municipal Health Officer The Kolkata Municipal Corporation Required a certified extract form the Death Register in respect of the following : 1. Name : 2. Age: 3. Sex: 4. Caste : 5. Profession : 6. Place of death : 7. Date of date : 8. Date of Registration : 9. Place where the body was disposed of : (Wooden or Electric Furnace in case of Keoratola & Nimtala) 10. No of copies required : 11. Fee paid Rs : Signature of applicant Name of address : Date SCALE OF FEE FOR BIRTH & DEATH REGISTRATION CERTIFICATE Certified extract in respect of one person. Fee per additional copy 50/ Searching fee when definite date & place are not given. Fee per year 10/
