HomeMy WebLinkAboutdeaths records form blank (1) NEW Y ORK STATE DEPARTMENT OF HEALTH
RECORD OF DEATHS
The following instructions to Physicians, Undertakers and Registrars should be read carefully;
r. Use only death certificate blanks supplied by the State Department of Health, Albany, N.Y. They,may be obtained of the City,Town,or VMage
Registrar of Vital Statistics.
rz. Upon notification of the death of any person, it is the duty of the undertaker to obtain the required personal and statistical particulars called for on #hs
certificate of death, from some member of the family of the deceased, or some competent person who is ably to furnish the facts, over the signature and address
of his informant. He shall then present the certificate to the attending physician, who shall forthwith fill`tiut and sign the medical certificate of death, giving
full name of deceased: medical attendance, date and probable cause of death. The undertaker shall then site the facts required relative to the date and place of
burial, over his signature and with his address, and present the certificate to the local registrar of vital statistics and obtain a burial permit before removing the
corpse for burial.
3. Write legibly, with durable black ink. This is a permanent official record. I
4. Death certificates must have the name of the deceased written in full; initials only will not be accepted. in the case of a married woman her given
name must be written.
g. Fill in at the top of the death certificate the name of the county, adding that of the town, city or villP^^ in which the death occurs.
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6. When any item called ftir cannot be obtained, the woY d "1Jxak w n" must be written.
q. Undertakers or other persons having charge of a dead body for burial, or removal, MUST obtaip a permit from the local Registrar,his Deputy,
or a Subregistrar duly authorized to issue burial or transit permits, prior tc the burial or removal of the dead 'i y.
burial permits issued b a Subregistzar, he should l�z .ke fretr that the certificate of de` as been properly filled out before issuing such j
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permit, and promptly,forward the ct.rtiiicate of death to the loci :E trarr.
g. No permit should be isseed by the local Registrar, Dcputp or Subregirtra r for the burial or rIocol pl (d c>, corpse until the death certificate has been
properly and completely filled out ea, required by law.
READ 1 S'�`P `'T°TO�t� 0� �4ID� OF CO
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