04/07/2021
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Example of Medical Death Certificate
Writings / / July 04, 2021
The medical death certificate, in a document issued by a private or institutional doctor that fully has his documents that certify him as a qualified doctor.
It carries the data of the doctor, such as his full name, professional identification number, information about his training; this document can be found foliated.
Death certificate example:
DEATH CERTIFICATE
No. Certificate 0006359
Dr. Manuel Morales Martínez
Surgeon and obstetrician Ced. Prof. 00058800223 exp. by SEP
Professional practice in a private office "Consultorio Morales"
With this document I certify the death of:
1st Names of the deceased
2nd Surname of the deceased
3rd Surname of the deceased
Date of birth: _________
Identity documents:
Birth certificate: _________________
Voting lisense: _______________
Identity card: _______________
Passport: ________________________
Residence card: _______________
Other: ____________________________
Causes of death:
1st Immediate cause: Time_____ Day ____ Month____ year ____
2nd Causes antecedents _____________________________________
3rd Initial or fundamental cause ________________________________
4th Other processes __________________________________________
Fill in case of signs of violent death
Autopsy was performed:
_________________________________________
I certify the raising of this death certificate on the ____ date of the month of ____ of the year ____.
Dr Dr. Manuel Morales Martínez
Firm
You can request your examples in the section of questions.
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