Background: Death certificates are an important source of population-based mortality statistics . This information derived from death certificates has many important uses right from development of public health programs to allocation of health care resources. There is no adequate training received by the physicians for filling up of death certificates correctly. The resulting inaccuracies in completion of this information undermines the quality of the data derived from death certificates. Aim and Objective: To assess the completeness of Medical Certificate of Cause of Death (MCCD) and the knowledge, attitude and practices (KAP) of health personnel involved in registration system. Methods: A total of 1947 consecutive death certificates issued by community physicians were collected from 12 administrative wards of 4 zones of Vadodara Municipal Corporation (VMC) during June 2012 to November 2013. Different variables like personal action of deceased, information regarding sequence of the death event (medical part) and medico-legal portion were assessed for its completeness. Simultaneously, knowledge, attitude and practices of Registration of birth and death (RBD) staff related to filling up of the MCCD forms was assessed in different wards of VMC. Results: Out of 1947 MCCD forms only 21 (1.1%) MCCD certificates in the study were completely filled, while 1877 (97%) were notably incomplete, 4 (0.2%) slightly incomplete and 45 (2.3%) grossly incomplete. On assessing KAP of RBD staff, none of them had been imparted the training related to registration system. Almost 87% of them were dissatisfied with the completeness of MCCD-form 4A filled up by private practitioners. Majority of them (68.8%) felt that they were overburdened due to paucity of staff. Conclusion: In conclusion, the combined effort of physicians and RBD staff is required to improve the quality of diagnostic information in death certificates. Thus, more accurate cause-of-death statistics derived from death certificates will lead to better health planning.