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Tanzania Sharing Association

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Jina Kamili/Full name

Anuani ya Makazi/Address

Namba ya Simu/Phone number

Jina la Marehemu/Name of the deceased

Uhusiano/Relationship

Tarehe ya Kifo/Date of Death

Month

Day

Year

Tarehe na Mahali alipofariki/Place of death

Chanzo cha Kifo/Cause of Death

Tarehe na Mahali pa Maziko/Date and Place of Burial

Jina la Ndugu #1 na Namba ya simu/Relative's Name and Phone #

Jina la Ndugu #2 na Namba ya Simu/ Relative's Name and Phone #

*Je Utapenda Kutembelewa?/ Would you like to be visited?

Ndiyo/Yes

Hapana/No

Nitawajulisha/ I will let you know

Kama Ndiyo, Mahali Ulipo Msiba (Anuani)/ If Yes Give the Address

Sahihi/Signature

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