Certification of Attending Physician for Death Claim - Philam Life 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the deceased’s full name, occupation at the time of death, and residence details including street, city, and province.
3. Provide personal details about the deceased such as age, sex, height, approximate weight, and hair color. Indicate if there were any identification marks on the body.
4. Answer how long you have known the deceased and provide the date and place of death. If applicable, specify if it was in a hospital or institution.
5. Detail your consultation history regarding the condition that caused death. Include who consulted you and the length of hospitalization.
6. List all conditions treated prior to the last illness along with dates, duration, and results of treatment.
7. Provide names and addresses of other physicians who attended to the deceased in the past three years.
8. Indicate if death was due to suicide, homicide, or accident and whether substances were involved at that time.
9. Complete any inquiries regarding cause of death or post-mortem examinations if applicable.

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