CHANDIGARH ADMINISTRATION AFFIDAVIT (Correction in the Death Report) I,s/oResident ofDo Solemnly affirm and declare as under:-That Sh. / Smt.S/Admittedand died2. That the Name of the deceased ShS/o, w/oWrongly been mentioned asPet/nick Name in the Hospital record.3. That the body of Sh. /Smt.S/o, w/o,was cremated And The Name of the deceased Mentioned there as4. That the correct and full Name of the deceased Iss/o, w/Is as5. That Sh.is the real NaturalSon of Sh.and was Adopted bySh.s/Or B. That Smt.w/oHas neither been acquired either by S/o6. That the no person Namedin family.That Sh/Smt.is knows BothThe Names asin his/her family.PlaceDatedDEPONENTVerification: The contents of the above statement true and correct to the best of my knowledge belief and nothing has been concealed therein. DEPONE
