Get Correct A Virginia Death Certificate
FORMATION AS REPORTED ON THE ORIGINALLY REGISTERED CERTIFICATE St. Affidavit No. .............................................. HEALTH DIVISION OFFICE OF VITAL RECORDS 1b. MIDDLE NAME 2. SEX 3. DATE OF BIRTH / DEATH 4. PLACE OF OCCURRENCE (City or County) 5. NAME OF FATHER 7. ITEM NO. Local Registration No. ..................................... 1c. LAST NAME 6. MAIDEN NAME OF MOTHER 8a. 8b. FACTS EXACTLY AS STATED ON THE ORIGINAL RECORD FACTS AS THEY SHOULD HAVE BEEN STATED ON TH.
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