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International Medical Certificate of Cause of Death Form 7/14

The International medical certificate of cause of death was designed to facilitate the identification of the underlying cause of death when multiple conditions exist at time of death.  For this reason it is divided into 2 parts.  Part 1 is designed to capture the chain of events or causal sequence leading directly to death and makes provision for up to four conditions - lines (a) to (d).  The immediate cause of death or condition leading directly to death is captured on the top line followed in chronological/pathophysiological sequence by any antecedent cause on the line below the immediate cause.  The underlying causes of death – that is the condition that initiated the sequence of events leading to death - should be captured on the lowest completed line.  Part 2 is designed to capture any co-existing conditions at the time of death, which contributed to the death, but do not fit into the causal sequence in Part 1.  Conditions reported in Part 1 and Part 2 should NOT include symptoms, signs and modes of dying.