English translation template for resident death medical certificateMedical Certificate of DeathCode of Administrative Division No：Name of the De

Translation:

Medical Certificate of Death

Administrative Division Code: No:

Name of Deceased:

Gender: Ethnic Group: Han

Country or Region:

Age: Type of ID: ID Card

ID Number:

Permanent Address:

Date of Birth:

Date of Death:

Place of Death:

Other Places and Miscellaneous:

Cause of Death: Sudden Death

Name of Family Member:

Contact Number:

Address of Family Member:

Signature of Doctor:

Signature of Police:

Seal of Medical and Health Organization:

Opinion of Local Police Station (Seal):

Date: December 12, 2017

Note: The family members of the deceased must provide this medical certificate of death to the public security bureau to cancel the deceased's household registration. This medical certificate of death is not valid without the signatures of the doctor and police, as well as the official seal of the medical and health organization and the local police station