Certificate Of Death/Incapacitation Of Military / Para Military Personnel

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Certificate Of Death/Incapacitation Of Military/Para Military Personnel

 

Certified that Mr./Ms.___________________, is the son/daughter/spouse of Shri _____________________ rank ______________________.

Shri _________________ was killed/incapacitated in action on ________________ (mention date), and his death/incapacitation did not occur due to an accident while performing a routine duty pertaining to job requirement.

 

Date Seal Signature of Authorized Officer

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