Death Certificate !!INSTALL!! Download Hyderabad

In a latest development pertaining to the scam in issue of birth and death certificates, GHMC authorities have written to the four police commissionerates in the purview of the corporation, requesting inquiry and action.

It is reliably learnt that letters were addressed by the Chief Medical Officer of Health (CMHO) to the Hyderabad, Cyberabad, Rachakonda and Medak police commissioners requesting a thorough inquiry into the certificate scam and legal action against the guilty.

Death Certificate Download Hyderabad

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The scam originated due to Government Orders issued previously, simplifying the process for issue of the certificates. Accordingly, the applications were being processed through Mee Seva centres and the need for field verification by the birth & death registrars or AMOHs was done away with for obtaining non-availability certificate, when the application was made with a delay of over a year after the occurrence.

The second task at hand i.e. issuing Medical Certificate of Cause of Death, is done immediately after deciding the person is dead, by the same medical officer who has declared the person dead, provided the medical officer is absolutely certain of the cause of death and if it is a natural death. Deaths due to old age and deaths due to any naturally occurring disease or its complication are Natural Deaths. Correct knowledge of the cause of death is essential as future course of action is different if the death is other than natural or cause of death is not known/doubtful. The form used for certification of cause of death in some countries like UK includes a statement from the certifying doctor that he has attended the deceased during his terminal illness or within 14 days prior to his death [1]. This indirectly means that if the doctor has attended the deceased only during his terminal moments or was called after death, he can not certify the cause of death as he will not have certain knowledge of the same. This time limit of 14 days is applicable even if the individual is a regular patient of the doctor and was suffering from a known chronic illness, as the cause of death may still be different. It is better that even medical officers practising in India, presume that the ruling exists in India as well.

If the death is not clearly of natural category i.e.other than natural or cause not known/doubtful, the medical officer having carried out first task i.e. declaration of death, informs the police of occurrence of the death for further course of action. He will not issue a medical certificate of cause of death. Since the bottom portion of the medical certificate of cause of death is required to be produced by the relatives at the cremation ground/the municipality office giving permission for cremation, non-issuance of the same will automatically ensure that the body can not be cremated.

Having taken over the custody of the dead body, the investigating police officer proceeds with inquest and the cause of death is decided after the medico-legal postmortem is carried out as part of the inquest.

This system ensures that the body is not disposed off without necessary investigations by the police into the cause and circumstances of death, when the death is due to other than natural causes. The medical certificate of cause of death is filled up either by the medical officer who carries out the medico legal autopsy or by the hospital administrative authorities immediately on conclusion of the autopsy. Since the medico legal postmortem is carried out on orders of the investigating police officer/coroner/magistrate, the medical certificate of cause of death is forwarded to these authorities only, by the certifier, and not directly handed over to the relatives of the deceased. The police authorities will handover the relevant (bottom) portion of the certificate to the relatives while handing over the dead body to them, which is done when the investigating officer decides that the dead body is no more required for investigations. A copy is forwarded to the death registering authorities by the police along with the death report forms.

The first portion of the form gives the available information about the personal particulars of the deceased including date and time of death. As regards the date and time of death, the date and time at which the certifier decides that the individual is dead (somatic death), is the date and time of death. Since the medical officer can not declare a person dead without attending and examining him, this entry will be of the time when he has first seen the individual dead, irrespective of when the death has occurred. For example, if the old man has died during his sleep at night and medical officer examines him at 0600 hours on next morning, the individual is declared to have died at 0600 hours. However, all such cases of deaths, unattended by a medical officer, are to be reported as medico-legal deaths. The actual time of death will then be decided during the inquest and post mortem examination along with the cause of death. Since the medical certificate of cause of death is filled after the post mortem examination, the legal time of death will be registered as that decided after the inquest. Similarly, dilemma may arise in situations of prolonged attempts to revive a person thought to be in suspended animation. The time of death then is when revival measures are considered futile and stopped. Thirdly, some hospitals have a rule that the dead body, in case of a ward death, is to be retained in the ward for 2 hours and is to be examined for signs of life frequently during that period, before being sent to mortuary. This is to ensure the death is not wrongly diagnosed, not an uncommon occurrence especially during epidemics, mass disasters etc. Under such circumstances, the decision of the certifying medical officer is final and the time of death can be entered as anytime during those two hours when the medical officer is convinced of its occurrence.

If the individual was suffering from any other disease which is not related to the underlying cause and hence can not be part of the sequence, but, in the opinion of the certifier, has contributed to death, such a condition too is to be recorded in the certificate. However, if the co-existing disease has not contributed to death, it has no place in the medical certificate of cause of death. Thus the certificate, unlike his medical records, is not a list of all diseases which the individual was suffering from at the time of death.

The above-mentioned details about the cause of death are entered in a definite format, approved by WHO. Information under I pertains to the underlying cause of death, antecedent cause of death and immediate cause of death, written from below upwards, clearly depicting the sequence of events ending with immediate cause written under (a). The sequence will give the order of relationship between events leading to death both with respect to time and etiological or pathological relationship. The importance of recording the sequence correctly lies in the fact that appropriate strategies can be adopted to cut the chain at its most vulnerable point and thus prevent death. The original format, approved by WHO, had only (a), (b) and (c) under I, but as per recommendations of Forty-Third World Health Assembly 1990, an additional line (d) has been added below (c) [4].

Example: When the death is due to lobar pneumonia, it is the Underlying, Antecedent and Immediate cause of death. Hence LOBAR PNEUMONIA will be entered under (a) and (b), (c) and (d) will be left vacant.

Most formats of death certificates require the certifier to provide certain epidemiological information about the deceased. Having furnished the details about the cause of death, information about associated pregnancy & delivery is asked. Obviously these columns are not applicable if the deceased is a male and the entries have to be made even if the cause of death is in no way related to pregnancy or delivery. This information is sought, considering the vulnerability of women to death during pregnancy and delivery. Similarly opinion about the manner of death i.e. accident / suicide / homicide is to be provided if possible. However, the most important part of the certificate is the portion giving details of cause of death.

Having provided all the available information to the best of his knowledge, the certifier signs the certificate giving his name, qualifications, designation and registration number. The date and time of signature will be the same as that of death mentioned in the beginning of the certificate, except in cases where the cause of death has been certified after an autopsy.

The bottom portion of the medical certificate of cause of death is to be filled up by the certifier, detached and handed over to the relatives. This document enables them to get the municipal permission for cremation as well as acts as reference to obtain the extract of the death register (Death Certificate) from the registering authority. It may be noted that this portion, handed over to the relatives does not mention the medical cause of death. Even the Death Certificate issued by the registering authority does not mention the medical cause of death. This procedure is adopted to maintain confidentiality of information of the cause of death in accordance with section 17(1) (b) of Registration of Births & Deaths Act of 1969. Hence, the certifier should send the medical certificate of cause of death along with death report forms to the registering authority directly. Thus the medical cause of death is entered and available only in the Death Register maintained by the registering authority. The convenient practice of sending a copy of the entire medical certificate of cause of death through the relatives to the registering authority violates the above mentioned section of the act.

Section 17(1) (b) of Registration of Births & Deaths Act also states that any person can obtain the extract from the Death Register of registering authority (death Certifier) on payment of the laid down fees along with an application. e24fc04721