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TYPE OROREGON DEPARTMENT OF HUMAN SERVICES CENTER FOR HEALTH STATISTICS 136CERTIFICATE OF DEATHPRINT IN PERMANENT BLACK INK.I.D. TAG NO.1. Legal NameFirstMiddleLastSTATE FILE NUMBER2. Death Date (MON DD YYYY)Sufx(Include AKAs, if any)3. Sex (M/F)4a. Age Last BirthdayTO BE COMPLETED BY FUNERAL FACILITY7. Birthdate (MON DD YYYY)4b. Under 1 Year4c. Under 1 DayMonthsHoursDays8a. Birthplace (City/Town, or County)10. Was Decedent of Hispanic Origin? (Yes or No
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How to fill out 136certificate of death

01
Obtain the official 136 certificate of death form from the relevant authorities.
02
Fill in the deceased's full name at the top of the form.
03
Enter the date of death in the designated field.
04
Provide the deceased's date of birth.
05
Fill in the deceased's place of death, including the city and state.
06
Indicate the cause of death as determined by the attending physician.
07
Include the deceased's occupation and any other relevant personal information.
08
Sign the form where indicated, usually by the attending physician or a designated official.
09
Submit the completed form to the appropriate government office for certification.

Who needs 136certificate of death?

01
Family members of the deceased for legal and financial purposes.
02
Executors of the deceased's estate to settle affairs.
03
Insurance companies for processing claims.
04
Government agencies requiring proof of death.
05
Hospitals or healthcare providers involved in the deceased's care.
06
Legal professionals for any probate or inheritance issues.
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The 136 certificate of death is a formal document that officially states the cause of death of an individual and is typically required for legal and administrative purposes.
The responsibility to file the 136 certificate of death usually falls on the attending physician, coroner, or other authorized individuals, depending on the jurisdiction.
To fill out the 136 certificate of death, the authorized individual must enter specific information such as the deceased's personal details, cause of death, and other required medical information according to the guidelines provided by the relevant authority.
The purpose of the 136 certificate of death is to formally document the death of an individual, provide legal proof of death, and facilitate the process of burial or cremation, as well as other administrative procedures involved in estate management.
The information that must be reported on the 136 certificate of death includes the deceased's full name, date of birth, date of death, cause of death, place of death, and details of the attending physician or coroner.
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