Death Certificate CME Project
PAGE CODE: CME  Section 2 -- Filling out the form -- Line 2 (2.line4)

Filling Out the Death Certificate

LINE 4

  DATE OF BIRTH 
 
This line helps in the identification of the decedent for legal purposes. It also helps verify the accuracy of the “AGE” item (line 5). 

Enter the exact month, day and year that the decedent was born. 

Use numbers or abbreviations, i.e. 11-1-1939, or No 1, 1939. 

If unknown, enter “Unknown.”  If exact day is not known, enter the month and year only, i.e. November, 1939 or 11/1939. 
 

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Last Revised: 6/12/99