DEATH CERTIFICATE REQUEST
LOS SANTOS DEPARTMENT OF MEDICAL EXAMINER-CORONER
SPACER
Provide full or partial search input using the following fields:
Code: Select all
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[center][b][size=170]DEATH CERTIFICATE REQUEST[/size][/b][/center]
[center][size=65]LOS SANTOS DEPARTMENT OF MEDICAL EXAMINER-CORONER[/size][/center]
[color=transparent]SPACER[/color]
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[center]Provide [b]full[/b] or [b]partial[/b] search input using the following fields:
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[br][/br][accordionfixed=1;REQUESTER'S;][color=#535a6c][justify][hr][/hr]
[b]Full Name:[/b] ANSWER
[b]Address:[/b] ANSWER
[b]Occupation:[/b] ANSWER
[b]Contact Number:[/b] ANSWER
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[br][/br][accordionfixed=1;DECEDENT'S;][color=#535a6c][justify][hr][/hr]
[size=85](If you are requesting for multiple bodies, you can number them instead of separate topics. EX: John Doe (1), John Doe (2))[/size]
[b]Full Name:[/b] ANSWER
[b]Gender:[/b] ANSWER
[b]Ethnicity:[/b] ANSWER
[b]Known Date of Death:[/b] DD/MMM/YYYY
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[br][/br][accordionfixed=1;NATURE OF REQUEST;][color=#535a6c][justify][hr][/hr]
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[b]Are you a legal relative of the victim?[/b]: YES/NO
[b]Explain the nature of your request:[/b] FILL HERE IF THE ANSWER ABOVE IS NO
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[br][/br][accordionfixed=1; (( OOC DETAILS ));][color=#535a6c][justify][hr][/hr]
You should fill below in case we cannot find a relevant case in our database.
[b]PK/CK[/b]: ANSWER
[b]Exact Date of Death if known[/b]: ANSWER
[b]How did they die?[/b]: ANSWER
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