死亡证明英文模板Residents Death Medical Certificate
№:0000000
Name of the deceased
Sex
1.M 2.F
Ethnic:
Major occupations and work type:General Worker
ID №:
Permanent residence address:
ADDRESS: XXX
(Following is filled in by the statistician) The ba...
Residents Death Medical Certificate
№:0000000
Name of the deceased
Sex
1.M 2.F
Ethnic:
Major occupations and work type:General Worker
ID №:
Permanent residence address:
ADDRESS: XXX
(Following is filled in by the statistician) The basic cause of death:
ICD code: Statistical classification number:
External Causes of Injury Poisoning: E-code: Statistical Category Number:
Investigation record
Premortem medical history and symptoms and signs:
Seal: XXX City Health Bureau
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