Medical certificate for cause of death
I,…......................................................................of ………………………………………………………………………………..do
hereby certify that I have medically attended ……................of ……………………………………….
who was (a) apparently, or stated to be …………………years that I last saw ………………
on the ……………………………………20 ……………………was suffering from ………………………….
that …………………………………………….died as I am aware, or (b) informed, on the ……..
day of …………………………………….,20 ……………………………, at (c)…………………………………..
and that the cause of death was to the best of my knowledge or belief as herein stated—
Primary cause ……………………………………………………………………………………....................
Secondary cause ………………………………………………............................................
(d) and that the disease had continued ……………………………………………………………………


[cut]


* State address
(a) Omit "apparently" or "or stated to be" as the case may be;
(b) Omit "aware or" when hour of death is known from report;
(c) State the time;
(d) State duration of illness if possible.

- https://www.placng.org/lawsofnigeria/laws/B9.pdf - pages 64 - 65