Medical Certificate of Cause of Death

(Hospital in-patients, Not to be used for still births)

To be sent to Registrar along with Form No. 2 (Death Report)

{{ (isset($value->name) && ($value->name != "") ? $value->name : "")}}, I hereby certify that the person whose particulars are given below died in the hospital in Ward No. {{ (isset($value->ward_type_id) && ($value->ward_type_id != "") ? $value->ward_type_id : "")}} {{ (isset($value->died_at) && ($value->died_at != "") ? date('d-m-Y \a\t h:i a', strtotime($value->died_at)) : "")}}

Name of Deceased	{{ (isset($value->name_of_deceased) && ($value->name_of_deceased != "") ? $value->name_of_deceased : "")}}
Age of Death	0 years, 0 months,
Gender	{{ (isset($value->gender) && ($value->gender != "") ? $value->gender : "")}}
Immediate Cause	{{ (isset($value->immediate_cause) && ($value->immediate_cause != "") ? $value->immediate_cause : "")}}
Antecedent Cause I	{{ (isset($value->antecedent_cause_1) && ($value->antecedent_cause_1 != "") ? $value->antecedent_cause_1 : "")}}
Antecedent Cause II	{{ (isset($value->antecedent_cause_2) && ($value->antecedent_cause_2 != "") ? $value->antecedent_cause_2 : "")}}
Other Significant Conditions	{{ (isset($value->other_significant_conditions) && ($value->other_significant_conditions != "") ? $value->other_significant_conditions : "")}}
Interval between on set & death approx.	{{ (isset($value->interval_between_on_set_death_approx) && ($value->interval_between_on_set_death_approx != "") ? $value->interval_between_on_set_death_approx : "")}}
How did the injury occur?	{{ (isset($value->how_did_the_injury_occur) && ($value->how_did_the_injury_occur != "") ? $value->how_did_the_injury_occur : "")}}
Manner of Death	{{ (isset($value->manner_of_death) && ($value->manner_of_death != "") ? $value->manner_of_death : "")}}
Was the death associated with preganancy?	{{ (isset($value->Was_the_death_associated_with_preganancy) && ($value->Was_the_death_associated_with_preganancy != "") ? $value->Was_the_death_associated_with_preganancy : "")}}
Was there a delivery?	{{ (isset($value->as_was_there_a_delivery) && ($value->as_was_there_a_delivery != "") ? $value->as_was_there_a_delivery : "")}}