Sample Death certificate | How to write death certified

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This is to certify that XXXXXXXX(Name of died person)  age of 79 years (according to PAN card) son of late xxxx (Name of father of x/x xxx Road , New city (address) expired today (10-01-2009) at 10:45PM due to sudden cardiac respiratory failure. He was suffering from xxxX (Name of disease) .

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