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Get PH Municipal Form No. 103 1993

_________________ Number ____________________ Date Issued _________________ 23. AUTOPSY _____ 1 Yes _____ 2 No 24. NAME AND ADDRESS OF CEMETERY OR CREMATORY 85 25. INFORMANT Signature _______________________________ Name in Print ____________________________ Relationship to the deceased ________________ Address _______________________________ _______________________________ Date _______________________________ 26. PREPARED BY 27. RECEIVED AT THE OFFICE OF THE CIVIL REGISTRAR Signature _.

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