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GOBIERNO DE PUERTO RICO

GOBI ERNO DE P UERTO RI CO D e p a r t a m e n t o d e S a l u d R e g i s t r o D e m o g r f i c o P O B O X 1 1 8 5 4 S a n J u a n , P u e r t o R i c o 0 0 9 1 0-1 8 5 4 w w w . s a l u d . g o v . p r (7 8 7 ) 7 6 5-2929 GOVERNMENT OF PUERTO rico DEPARTMENT OF HEALTH DEMOGRAPHIC REGISTRY APPLY FOR DEATH CERTIFICATE BY MAIL M RD 225 PART I: INFORMATION OF DECEADED Revised 05/2017 Name: Last Name Maiden Name First Name Middle Name of Death: (mm/dd/yyyy) of Death: (Country) s Name: s Name: : of Copies If you want Original Death Certificate (Cause of Death) _____ Yes _____ No Cost of the Certificate.

GOBIERNO DE PUERTO RICO Departamento de Salud Registro Demográfico • PO BOX 11854 San Juan, Puerto Rico 00910-1854 •www.salud.gov.pr• (787)765-2929

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  Salud, Puerto, Rico, Puerto rico, De salud, Gobierno, Gobierno de puerto rico

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