Completing a Vermont Certificate of Death

Name Known to Physician and Date of Death

The name known to physician is just that. The patient's name as you know it to be. For Example, you may know the man as Al Newman. This is what you should enter. Alfred Edward Newman IV, may actually be the deceased's full name. This information will be entered by the funeral director.

The date of death is the date the person is pronounced dead.

Definitions

Before moving on to the remaining sections, we will first define several key terms and concepts:

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