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This Cause of Death and the Death Certificate Form is a very helpful file for those that want to learn about the Death Certificate. The several pages of information introduce the knowledge of Death Certificate in detail. Read it carefully and you'll get wide information about Death Certificate. The form is also very typical. You can download the template and fill in the form according to the instructions.

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Cause of Death and the Death Certificate
© 2006 College of American Pathologists
10
The Cause-of-Death Section
This basic summary will concentrate on the cause-of-death section because it is the part
of the death certificate completed by the attending physician, medical examiner, or
coroner. The following generic template will be used to provide examples of cause-of-
death statements.
Note that the cause-of-death statement contains Part I and Part II. The
use of Part I and Part II will be described in further detail below. This general template
for the cause-of-death statement is applicable to each state.
A.
Due to, or as a consequence of:
B.
Due to, or as a consequence of:
C.
Part I
Due to, or as a consequence of:
D.
Part II
OTHER SIGNIFICANT CONDITIONS: Conditions contributing to death but not resulting in the underlying cause of death in Part I
The items shown above are the critical ones in terms of the cause-of-death statement
itself. Other related items, such as dates, places, times, role of tobacco, pregnancy
information, and other items in the cause-of-death section, will be discussed individually
because they are not as integrally related to the cause-of-death statement itself, and there
are rules and procedures that need to be discussed for each item.
In general, the cause-of-death section is designed to record a sequence of conditions in
Part I and to list other significant contributing conditions in Part II.
A. Most recent condition
Due to, or as a consequence of:
B. An older condition
Due to, or as a consequence of:
C. An even older condition
Part I
Due to, or as a consequence of:
D. Oldest condition (what started it all)
Part II
OTHER SIGNIFICANT CONDITIONS: Conditions contributing to death but not resulting in the underlying cause of death in Part I
Something that contributed to death but did not cause the
sequence listed above in Part I
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