BENGALURU: The Karnataka government has issued detailed instructions to strengthen the Medical Certification of Cause of Death (MCCD) system across the state, following an ICMR study and review meetings held on April 21 and October 18, 2025. Reliable cause-specific mortality data is essential for policymakers, but currently, only 26.73% of registered deaths in Karnataka have a medically certified cause.
The new guidelines follow the Karnataka Registration of Births and Deaths (Amendment) Rules, 2024, notified on December 31, 2024, and in effect since January 16, 2025.
As per the rules, all government and private hospitals must issue a cause-of-death certificate in Form 4 for all in-house deaths, submit it electronically through e-JanMa, and provide a copy to the family. Monthly reporting of deaths and MCCDs is mandatory, and institutions must file a ‘nil’ report if no deaths occur.
For deaths occurring outside medical institutions, the doctor must issue Form 4A free of charge. If the treating doctor is unavailable, other doctors familiar with the patient’s history—or medical officers from PHCs, CHCs, or taluk and district hospitals—may issue the certificate after taking a history from the family.
Registrars have been instructed to ensure that Form 2 (death report) is accompanied by Form 4 or 4A, and to forward all certificates to the Chief Registrar by the 10th of the following month. In inquest cases, the investigating officer must provide cause-of-death information, and the attending or autopsy doctor must submit Form 4/4A.