The certificate of death shall contain, as a minimum, the following items:

            (1) Full name of the decedent.

            (2) The social security number issued to the decedent, unless a social security number cannot be obtained.

            (3) Sex.

            (4) Race.

            (5) Ethnicity.

            (6) Conjugal status; single, married, widowed, or divorced. If married, name of spouse.

            (7) Age, in years, months, and days. If less than one day, in hours or minutes.

            (8) Occupation, including any remunerative employment; the trade, profession, or particular kind of work; the general nature of the industry, business, or establishment in which employed.

            (9) Place of residence, address, including city or town and state.

            (10) Date of birth, including year, month, and day.

            (11) Place of birth; if of foreign birth, how long in the United States.

            (12) Name and birthplace of father.

            (13) Maiden name and birthplace of mother.

            (14) Place of death, address, including city or town and state.

            (15) Name and address of the informant of the above items. The informant may be any competent person acquainted with the facts, attesting to the accuracy of the above information.

            (16) Official signature of the local registrar, with the date when the certificate containing the above items was filed and the registered number of the certificate.

            (17) Date and place of burial, cremation, or removal.

            (18) Signature and address of undertaker, or person acting as such, on the statement of facts required in Paragraph (17) of this Section.

            (19) The medical certification of the physician, if any, last attending to the deceased, which certificate shall be made and signed by the physician within twenty-four hours after death with his name and address. In the absence of a physician, the parish coroner shall sign the certificate. In either event, the certification shall contain the following items:

            (a) The fact and date of death, including year, month, day, and the time of the day.

            (b) Time in attendance.

            (c) Time he last saw the deceased alive.

            (d) Cause of death, showing the course of the disease or the sequence of causes resulting in the death; and contributory or secondary causes, the duration of each, and whether any primary or secondary causes of death are attributed to dangerous or insanitary conditions of employment. If the cause of death was violent, the certificate shall show the determination of the coroner as to whether the death was probably accidental, suicidal, or homicidal.

            Acts 2016, No. 434, §3.