D4798979478/2015

Zone 05 Division 059

Name BOOPALAN

Name of Father / Husband R. GOVINDASAMI

Name of Mother .
Permanent Residential Address NO:2/43, GANDHI NAGAR, 1ST STREET, KARUNEELAM,
SINGAPERUMAL KOIL VIA, KANCHIPURAM 603204

Address of the deceased at the NO:2/43, GANDHI NAGAR, 1ST STREET, KARUNEELAM,
time of death SINGAPERUMAL KOIL VIA, KANCHIPURAM 603204

Sex Male
Age 52 YEARS
Date of Death 24-APR-2015
Place of Death RAJIV GANDHI GOVERNMENT GENERAL HOSPITAL E.V.R.
ROAD CHENNAI -600003

Registration Number 2015/05/059/002916/0

Date of Registration 09-MAY-2015
Date of Issue 16-AUG-2015
Remarks (If Any)

16-AUG-2015

Note : This certificate is computer generated and does not require any Seal/Signature in original.
The authenticity of this certificate can be verified at www.chennaicorporation.gov.in. The Registration
Number is unique to each death.