Last updated on Thursday, 15, October, 2026

Hospital Death Record Documentation: What PHC Indicators 153 and 154 Require

A hospital meets PHC Indicators 153 and 154 when the medical record of every patient who dies holds a copy of the death certificate showing the cause, date and time of death, signed and stamped by the Registrar, when the death is documented in the MR department, and when the final autopsy report is in the record whenever a clinical autopsy is carried out.

This guide explains what to file, shows where hospitals usually slip, and gives you a checklist your quality and records teams can start using this week.

Regulator	Punjab Healthcare Commission (PHC)
Standard	29 (IMS-2): the medical record reflects continuity of care
Indicators	153 and 154
Priority	Critical (both)
Applies to	Hospitals where patients die, and where clinical autopsies are carried out

These indicators are part of the PHC Information Management Systems standards. For all 19 indicators, see our guide to PHC Information Management Standards (IMS 28-30).

What PHC Indicators 153 and 154 Require

Indicator 153: the death certificate. In the case of death, the medical record contains a copy of the death certificate indicating the cause, date and time of death. The PHC adds three requirements:

1. All death records include the cause, date and time of death.
2. The certificate is signed and stamped by the Registrar.
3. All hospital deaths are documented in the MR (medical records) department.

Indicator 154: the autopsy report. Whenever a clinical autopsy is carried out, the medical record contains a copy of the report. The PHC asks for the final autopsy report.

Why They Are Critical Indicators

Indicators 153 and 154 are two of the six critical indicators in Standard 29, alongside admission and diagnosis (149), operative procedures (150), transfers (151) and discharge (152). A death is the final entry in a patient’s record, and families, the hospital and the regulator all rely on it. A missing certificate, an unsigned stamp or a death that never reached the MR department leaves the hospital unable to show what happened and when.

What the Record Must Contain

The PHC lists these requirements. The “what to check” column is practical guidance for ward, quality and medical records staff.

#	Indicator	PHC requirement	What to check	Example entry
1	153	A copy of the death certificate is in the record	The hospital’s file holds a copy, not only the family	Copy of certificate filed in the patient’s record
2	153	Cause of death	Stated clearly on the certificate and in the record	Cause as certified by the treating doctor
3	153	Date of death	Present, and matches the clinical notes	14 Oct 2026
4	153	Time of death	Present, and matches the clinical notes	03:40
5	153	Signed and stamped by the Registrar	Both signature and stamp are on the document	Registrar’s signature and stamp visible
6	153	All hospital deaths documented in the MR department	Every death on the wards also appears in the MR department’s records	Death logged in MR department on 14 Oct
7	154	Final autopsy report, when a clinical autopsy is carried out	The final report, not only a request or a preliminary note, is in the record	Final autopsy report filed on 28 Oct

The examples are illustrative only. Use your own details.

Match the details across the file. The date and time on the certificate should agree with the nursing and doctors’ notes. A mismatch is the first thing a reviewer will question.

Cross-check wards against the MR department. Because every hospital death must be documented in the MR department, a simple monthly comparison of ward death lists against the MR department list shows whether any are missing.

If no clinical autopsy was done, Indicator 154 does not call for a report. A short note in the record that none was carried out avoids questions later.

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Where Hospitals Usually Fail on Death and Autopsy Records

These are the gaps to look for in your own files. Each maps to the indicators’ wording.

• No copy of the certificate in the record. The family received it and the file holds nothing.
• Cause, date or time missing, or entered differently in different places.
• No Registrar signature, or no stamp, or only one of the two.
• A death that never reached the MR department. The ward knows, the records team does not.
• Only a preliminary autopsy note in the file, with the final report never filed (Indicator 154).
• The autopsy report kept in a separate place and not linked to the patient’s record.
• No one tracking pending autopsy reports, so they stay outstanding.
• No name, title, date or time next to entries. Like every entry, a death record should show who wrote it and when (Indicators 146 and 147).
• Illegible handwriting, which fails a legibility review (Indicator 159).

If your files show more than a few of these, a monthly check of all deaths in the period will show how widespread the problem is.

How to Comply with Indicators 153 and 154 in Six Steps

1. Set the process. Write down who completes the death certificate, how it reaches the Registrar for signature and stamp, and who files the copy.
2. Use one death form or checklist that captures cause, date and time, so the certificate and the clinical notes agree.
3. File a copy in the patient’s record as soon as the certificate is signed and stamped.
4. Report every death to the MR department and keep a list there, so all hospital deaths are documented (Indicator 153).
5. Track clinical autopsies. Log each one, follow up until the final report is issued, and file it in the record (Indicator 154).
6. Audit every month. Compare the ward death list with the MR department list, then check each file for a signed and stamped certificate and, where relevant, the final autopsy report. Document what you find and fix (Indicators 156 to 162).

Death Record Checklist

Print one per death, or copy it into your own system.

Item	Entry
Patient (name, age, sex, MRN, ward)
Date of death
Time of death
Cause of death
Copy of death certificate filed in the record (Y/N, date)
Signed and stamped by the Registrar (Y/N)
Death documented in the MR department (Y/N, date)
Clinical autopsy carried out (Y/N)
Final autopsy report filed in the record (Y/N, date)
Completed by (name and title)
Signature, date and time

How Hospital Software Helps with Death and Autopsy Records

On paper, the death certificate, the ward note and the MR department entry can end up in three different places. An electronic record brings them together.

With CoreMedix hospital management software and the Electronic Medical Record from InstaCare:

• The death is recorded in the patient’s own record, with cause, date and time as required fields.
• A scan of the signed and stamped certificate, and later the final autopsy report, can be stored in the same record.
• Every entry carries the author’s name, title, date and time automatically.
• Deaths can be listed from the records, so the monthly cross-check with the MR department is quick.
• Your quality team can review death records for completeness without searching paper files.

Want to see how it works on your own records? Request a demo.

Prepare Your Hospital for PHC Review

• Download the PHC IMS checklist: all 19 indicators, color-coded critical and non-critical.
• Request a demo to see how CoreMedix handles death records and the rest of the medical record.

Frequently Asked Questions

What Does PHC Indicator 153 Require?

In the case of death, the medical record must contain a copy of the death certificate showing the cause, date and time of death. It must be signed and stamped by the Registrar, and all hospital deaths must be documented in the MR department.

What Does PHC Indicator 154 Require?

Whenever a clinical autopsy is carried out, the medical record must contain a copy of the report. The PHC asks for the final autopsy report.

Are Indicators 153 and 154 Critical?

Yes. The PHC marks both as critical indicators under Standard 29 (IMS-2).

Who Signs the Death Certificate?

The PHC requires the certificate to be signed and stamped by the Registrar. Your hospital’s own policy should set out who completes it first and how it reaches the Registrar.

What Does “Documented in the MR Department” Mean?

Every death in the hospital must be recorded in the medical records (MR) department, not only on the ward. A monthly comparison of the ward list with the MR department list will show any that are missing.

How Can We Check That Our Death Records Comply?

Review all deaths in the period each month. Check each file for a copy of the certificate with cause, date and time, the Registrar’s signature and stamp, an MR department entry and, where a clinical autopsy was done, the final report. Record the gaps and the corrective action taken.