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Give me easy formet for this
Here is the information from the death certificate in a simple, easy-to-read format:
🏥 Medical Certificate of Cause of Death
Form No. 4 (See Rule 7)
👤 Patient Details
| Field | Details |
|---|---|
| Name | Ram Karan Gangwar |
| Sex | Male |
| Age at Death | 62 Years |
| Date of Death | 14 September 2025 |
| Time of Death | 10:15 AM |
🏨 Hospital Details
| Field | Details |
|---|---|
| Hospital Name | Rohilkhand Medical College & Hospital, Bareilly |
| Admitted On | 11 September 2025 |
| Expired On | 14 September 2025 |
⚕️ Cause of Death
| Type | Condition | Duration |
|---|---|---|
| Immediate Cause (a) | Myocardial Infarction (Heart Attack) | 8 Days |
| Antecedent Cause (b) | Hypertension (High BP) | 10 Days |
| Underlying Cause (c) | Diabetes | 8 Years |
👨👩👦 Family Details
| Field | Details |
|---|---|
| S/D/W of | Ram Sharan Gangwar |
| Resident of | Bareilly |
🩺 Certifying Doctor
| Field | Details |
|---|---|
| Doctor's Name | Dr. Aradhya Gosain |
| Designation | Medical Superintendent |
| Date of Verification | 14 September 2025 |
📋 Summary
Ram Karan Gangwar, a 62-year-old male, was admitted to Rohilkhand Medical College & Hospital, Bareilly on 11 Sept 2025 and passed away on 14 Sept 2025 at 10:15 AM due to Myocardial Infarction (heart attack), which was caused by long-standing Hypertension and Diabetes.
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