diff --git a/internal/domain/main-entities/death-cause/dto.go b/internal/domain/main-entities/death-cause/dto.go
new file mode 100644
index 00000000..8781ace8
--- /dev/null
+++ b/internal/domain/main-entities/death-cause/dto.go
@@ -0,0 +1,62 @@
+package death_cause
+
+import (
+	ecore "simrs-vx/internal/domain/base-entities/core"
+)
+
+type CreateDto struct {
+	Encounter_Id *uint   `json:"-"`
+	Value        *string `json:"value"`
+}
+
+type ReadListDto struct {
+	FilterDto
+	Includes   string `json:"includes"`
+	Pagination ecore.Pagination
+}
+
+type FilterDto struct {
+	Encounter_Id *uint `json:"encounter-id"`
+}
+
+type ReadDetailDto struct {
+	Id uint16 `json:"id"`
+}
+
+type UpdateDto struct {
+	Id uint16 `json:"id"`
+	CreateDto
+}
+
+type DeleteDto struct {
+	Id uint16 `json:"id"`
+}
+
+type MetaDto struct {
+	PageNumber int `json:"page_number"`
+	PageSize   int `json:"page_size"`
+	Count      int `json:"count"`
+}
+
+type ResponseDto struct {
+	ecore.Main
+	Encounter_Id *uint   `json:"encounter_id"`
+	Value        *string `json:"value"`
+}
+
+func (d DeathCause) ToResponse() ResponseDto {
+	resp := ResponseDto{
+		Encounter_Id: d.Encounter_Id,
+		Value:        d.Value,
+	}
+	resp.Main = d.Main
+	return resp
+}
+
+func ToResponseList(data []DeathCause) []ResponseDto {
+	resp := make([]ResponseDto, len(data))
+	for i, u := range data {
+		resp[i] = u.ToResponse()
+	}
+	return resp
+}
diff --git a/internal/domain/main-entities/encounter/dto.go b/internal/domain/main-entities/encounter/dto.go
index 7fc15284..4a30281d 100644
--- a/internal/domain/main-entities/encounter/dto.go
+++ b/internal/domain/main-entities/encounter/dto.go
@@ -96,7 +96,7 @@ type MetaDto struct {
 }
 type DischargeDto struct {
 	Id                        uint                     `json:"id"`
-	DischargeMethod_Code      *ere.DischargeMethodCode `json:"dischargeMethod_code" validate:"maxLength=16"`
+	Discharge_Method_Code     *ere.DischargeMethodCode `json:"discharge_method_code" validate:"maxLength=16"`
 	EarlyEducation            *string                  `json:"earlyEducation"`
 	MedicalDischargeEducation *string                  `json:"medicalDischargeEducation"`
 	AdmDischargeEducation     *string                  `json:"admDischargeEducation"`
diff --git a/internal/interface/main-handler/encounter/handler.go b/internal/interface/main-handler/encounter/handler.go
index acbb5e08..6cf91832 100644
--- a/internal/interface/main-handler/encounter/handler.go
+++ b/internal/interface/main-handler/encounter/handler.go
@@ -1,6 +1,7 @@
 package encounter
 
 import (
+	"fmt"
 	"net/http"
 
 	rw "github.com/karincake/risoles"
@@ -84,6 +85,8 @@ func (obj myBase) Delete(w http.ResponseWriter, r *http.Request) {
 }
 
 func (obj myBase) CheckOut(w http.ResponseWriter, r *http.Request) {
+	const dataValidationVail = "data-validation-fail"
+
 	dto := e.DischargeDto{}
 	id := rw.ValidateInt(w, "id", r.PathValue("id"))
 	if id <= 0 {
@@ -95,7 +98,44 @@ func (obj myBase) CheckOut(w http.ResponseWriter, r *http.Request) {
 	}
 
 	// validate request body
-	if dto.DischargeMethod_Code == ere.
+	{
+		switch *dto.Discharge_Method_Code {
+		case ere.DMCDeath:
+			if dto.DeathCause == nil {
+				rw.DataResponse(w, nil, d.FieldError{
+					Code:    dataValidationVail,
+					Message: "deathCause required if discharge_method_code is death",
+				})
+				return
+			}
+		case ere.DMCConsulPoly, ere.DMCConsulExecutive:
+			if dto.InternalReferences == nil {
+				rw.DataResponse(w, nil, d.FieldError{
+					Code:    dataValidationVail,
+					Message: fmt.Sprintf("internalReferences required if discharge_method_code is %s", *dto.Discharge_Method_Code),
+				})
+				return
+			}
+
+			for _, v := range *dto.InternalReferences {
+				if v.Unit_Id == nil {
+					rw.DataResponse(w, nil, d.FieldError{
+						Code:    dataValidationVail,
+						Message: "internalReferences.unit_id required",
+					})
+					return
+				}
+
+				if v.Doctor_Id == nil {
+					rw.DataResponse(w, nil, d.FieldError{
+						Code:    dataValidationVail,
+						Message: "internalReferences.doctor_id required",
+					})
+					return
+				}
+			}
+		}
+	}
 
 	dto.Id = uint(id)
 	res, err := u.CheckOut(dto)
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/case.go b/internal/use-case/main-use-case/ambulance-transport-req/case.go
index 712d6241..6810fe83 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/case.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/case.go
@@ -1,4 +1,4 @@
-package ambulancetransport
+package ambulance_transport_req
 
 import (
 	"errors"
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/helper.go b/internal/use-case/main-use-case/ambulance-transport-req/helper.go
index 3c739eb0..9ad4122d 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/helper.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/helper.go
@@ -2,7 +2,7 @@
 DESCRIPTION:
 Any functions that are used internally by the use-case
 */
-package ambulancetransport
+package ambulance_transport_req
 
 import (
 	"errors"
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/lib.go b/internal/use-case/main-use-case/ambulance-transport-req/lib.go
index e8555a6f..eca1c5b9 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/lib.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/lib.go
@@ -1,4 +1,4 @@
-package ambulancetransport
+package ambulance_transport_req
 
 import (
 	"errors"
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/middleware-runner.go b/internal/use-case/main-use-case/ambulance-transport-req/middleware-runner.go
index b98c497d..18937f5c 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/middleware-runner.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/middleware-runner.go
@@ -1,4 +1,4 @@
-package ambulancetransport
+package ambulance_transport_req
 
 import (
 	atr "simrs-vx/internal/domain/main-entities/ambulance-transport-req"
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/middleware.go b/internal/use-case/main-use-case/ambulance-transport-req/middleware.go
index 847aa3dd..cc1f7c3e 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/middleware.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/middleware.go
@@ -1,4 +1,4 @@
-package ambulancetransport
+package ambulance_transport_req
 
 // example of middleware
 // func init() {
diff --git a/internal/use-case/main-use-case/ambulance-transport-req/tycovar.go b/internal/use-case/main-use-case/ambulance-transport-req/tycovar.go
index 5d3ac027..54f8f604 100644
--- a/internal/use-case/main-use-case/ambulance-transport-req/tycovar.go
+++ b/internal/use-case/main-use-case/ambulance-transport-req/tycovar.go
@@ -6,7 +6,7 @@ In this sample it also provides type and variable regarding the needs of the
 middleware to separate from main use-case which has the basic CRUD
 functionality. The purpose of this is to make the code more maintainable.
 */
-package ambulancetransport
+package ambulance_transport_req
 
 import (
 	"gorm.io/gorm"
diff --git a/internal/use-case/main-use-case/death-cause/case.go b/internal/use-case/main-use-case/death-cause/case.go
new file mode 100644
index 00000000..484c0f66
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/case.go
@@ -0,0 +1,228 @@
+package deathcause
+
+import (
+
+	// main entities
+	edc "simrs-vx/internal/domain/main-entities/death-cause"
+	"strconv"
+
+	pl "simrs-vx/pkg/logger"
+	pu "simrs-vx/pkg/use-case-helper"
+
+	dg "github.com/karincake/apem/db-gorm-pg"
+	d "github.com/karincake/dodol"
+	"gorm.io/gorm"
+)
+
+const source = "death-cause"
+
+func Create(input edc.CreateDto) (*d.Data, error) {
+	data := edc.DeathCause{}
+
+	event := pl.Event{
+		Feature: "Create",
+		Source:  source,
+	}
+
+	// Start log
+	pl.SetLogInfo(&event, input, "started", "create")
+
+	err := dg.I.Transaction(func(tx *gorm.DB) error {
+		mwRunner := newMiddlewareRunner(&event, tx)
+		mwRunner.setMwType(pu.MWTPre)
+		// Run pre-middleware
+		if err := mwRunner.RunCreateMiddleware(createPreMw, &input, &data); err != nil {
+			return err
+		}
+
+		if resData, err := CreateData(input, &event, tx); err != nil {
+			return err
+		} else {
+			data = *resData
+		}
+
+		mwRunner.setMwType(pu.MWTPost)
+		// Run post-middleware
+		if err := mwRunner.RunCreateMiddleware(createPostMw, &input, &data); err != nil {
+			return err
+		}
+
+		pl.SetLogInfo(&event, nil, "complete")
+
+		return nil
+	})
+
+	if err != nil {
+		return nil, err
+	}
+
+	return &d.Data{
+		Meta: d.II{
+			"source":    source,
+			"structure": "single-data",
+			"status":    "created",
+		},
+		Data: data.ToResponse(),
+	}, nil
+}
+
+func ReadList(input edc.ReadListDto) (*d.Data, error) {
+	var data *edc.DeathCause
+	var dataList []edc.DeathCause
+	var metaList *edc.MetaDto
+	var err error
+
+	event := pl.Event{
+		Feature: "ReadList",
+		Source:  source,
+	}
+
+	// Start log
+	pl.SetLogInfo(&event, input, "started", "readList")
+
+	err = dg.I.Transaction(func(tx *gorm.DB) error {
+		mwRunner := newMiddlewareRunner(&event, tx)
+		mwRunner.setMwType(pu.MWTPre)
+		// Run pre-middleware
+		if err := mwRunner.RunReadListMiddleware(readListPreMw, &input, data); err != nil {
+			return err
+		}
+
+		if dataList, metaList, err = ReadListData(input, &event, tx); err != nil {
+			return err
+		}
+
+		mwRunner.setMwType(pu.MWTPost)
+		// Run post-middleware
+		if err := mwRunner.RunReadListMiddleware(readListPostMw, &input, data); err != nil {
+			return err
+		}
+
+		return nil
+	})
+
+	if err != nil {
+		return nil, err
+	}
+
+	return &d.Data{
+		Meta: d.IS{
+			"source":              source,
+			"structure":           "list-data",
+			"status":              "fetched",
+			"page_number":         strconv.Itoa(metaList.PageNumber),
+			"page_size":           strconv.Itoa(metaList.PageSize),
+			"record_totalCount":   strconv.Itoa(metaList.Count),
+			"record_currentCount": strconv.Itoa(len(dataList)),
+		},
+		Data: edc.ToResponseList(dataList),
+	}, nil
+}
+
+func ReadDetail(input edc.ReadDetailDto) (*d.Data, error) {
+	var data *edc.DeathCause
+	var err error
+
+	event := pl.Event{
+		Feature: "ReadDetail",
+		Source:  source,
+	}
+
+	// Start log
+	pl.SetLogInfo(&event, input, "started", "readDetail")
+
+	err = dg.I.Transaction(func(tx *gorm.DB) error {
+		mwRunner := newMiddlewareRunner(&event, tx)
+		mwRunner.setMwType(pu.MWTPre)
+		// Run pre-middleware
+		if err := mwRunner.RunReadDetailMiddleware(readDetailPreMw, &input, data); err != nil {
+			return err
+		}
+
+		if data, err = ReadDetailData(input, &event, tx); err != nil {
+			return err
+		}
+
+		mwRunner.setMwType(pu.MWTPost)
+		// Run post-middleware
+		if err := mwRunner.RunReadDetailMiddleware(readDetailPostMw, &input, data); err != nil {
+			return err
+		}
+
+		return nil
+	})
+
+	if err != nil {
+		return nil, err
+	}
+
+	return &d.Data{
+		Meta: d.IS{
+			"source":    source,
+			"structure": "single-data",
+			"status":    "fetched",
+		},
+		Data: data.ToResponse(),
+	}, nil
+}
+
+func Update(input edc.UpdateDto) (*d.Data, error) {
+	rdDto := edc.ReadDetailDto{Id: input.Id}
+	var data *edc.DeathCause
+	var err error
+
+	event := pl.Event{
+		Feature: "Update",
+		Source:  source,
+	}
+
+	// Start log
+	pl.SetLogInfo(&event, input, "started", "update")
+
+	err = dg.I.Transaction(func(tx *gorm.DB) error {
+		pl.SetLogInfo(&event, rdDto, "started", "DBReadDetail")
+		if data, err = ReadDetailData(rdDto, &event, tx); err != nil {
+			return err
+		}
+
+		mwRunner := newMiddlewareRunner(&event, tx)
+		mwRunner.setMwType(pu.MWTPre)
+		// Run pre-middleware
+		if err := mwRunner.RunUpdateMiddleware(readDetailPreMw, &rdDto, data); err != nil {
+			return err
+		}
+		
+		if err := UpdateData(input, data, &event, tx); err != nil {
+			return err
+		}
+
+		// Get Updated Data
+		if data, err = ReadDetailData(rdDto, &event, tx); err != nil {
+			return err
+		}
+
+		pl.SetLogInfo(&event, nil, "complete")
+
+		mwRunner.setMwType(pu.MWTPost)
+		// Run post-middleware
+		if err := mwRunner.RunUpdateMiddleware(readDetailPostMw, &rdDto, data); err != nil {
+			return err
+		}
+
+		return nil
+	})
+
+	if err != nil {
+		return nil, err
+	}
+
+	return &d.Data{
+		Meta: d.IS{
+			"source":    source,
+			"structure": "single-data",
+			"status":    "updated",
+		},
+		Data: data.ToResponse(),
+	}, nil
+
+}
diff --git a/internal/use-case/main-use-case/death-cause/helper.go b/internal/use-case/main-use-case/death-cause/helper.go
new file mode 100644
index 00000000..c655a966
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/helper.go
@@ -0,0 +1,22 @@
+/*
+DESCRIPTION:
+Any functions that are used internally by the use-case
+*/
+package deathcause
+
+import (
+	e "simrs-vx/internal/domain/main-entities/death-cause"
+)
+
+func setData[T *e.CreateDto | *e.UpdateDto](input T, data *e.DeathCause) {
+	var inputSrc *e.CreateDto
+	if inputT, ok := any(input).(*e.CreateDto); ok {
+		inputSrc = inputT
+	} else {
+		inputTemp := any(input).(*e.UpdateDto)
+		inputSrc = &inputTemp.CreateDto
+	}
+
+	data.Encounter_Id = inputSrc.Encounter_Id
+	data.Value = inputSrc.Value
+}
diff --git a/internal/use-case/main-use-case/death-cause/lib.go b/internal/use-case/main-use-case/death-cause/lib.go
new file mode 100644
index 00000000..9f1d548b
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/lib.go
@@ -0,0 +1,140 @@
+package deathcause
+
+import (
+	"errors"
+	e "simrs-vx/internal/domain/main-entities/death-cause"
+	plh "simrs-vx/pkg/lib-helper"
+	pl "simrs-vx/pkg/logger"
+	pu "simrs-vx/pkg/use-case-helper"
+
+	dg "github.com/karincake/apem/db-gorm-pg"
+	gh "github.com/karincake/getuk"
+	"gorm.io/gorm"
+)
+
+func CreateData(input e.CreateDto, event *pl.Event, dbx ...*gorm.DB) (*e.DeathCause, error) {
+	pl.SetLogInfo(event, nil, "started", "DBCreate")
+
+	data := e.DeathCause{}
+	setData(&input, &data)
+
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	if err := tx.Create(&data).Error; err != nil {
+		return nil, plh.HandleCreateError(input, event, err)
+	}
+
+	pl.SetLogInfo(event, nil, "complete")
+	return &data, nil
+}
+
+func ReadListData(input e.ReadListDto, event *pl.Event, dbx ...*gorm.DB) ([]e.DeathCause, *e.MetaDto, error) {
+	pl.SetLogInfo(event, input, "started", "DBReadList")
+	data := []e.DeathCause{}
+	pagination := gh.Pagination{}
+	count := int64(0)
+	meta := e.MetaDto{}
+
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	tx = tx.
+		Model(&e.DeathCause{}).
+		Scopes(gh.Preload(input.Includes)).
+		Scopes(gh.Filter(input.FilterDto)).
+		Count(&count).
+		Scopes(gh.Paginate(input, &pagination)).
+		Order("\"CreatedAt\" DESC")
+
+	if err := tx.Find(&data).Error; err != nil {
+		if errors.Is(err, gorm.ErrRecordNotFound) {
+			return nil, &meta, nil
+		}
+		return nil, nil, plh.HandleListError(input, event, err)
+	}
+
+	meta.Count = int(count)
+	meta.PageNumber = pagination.PageNumber
+	meta.PageSize = pagination.PageSize
+
+	pl.SetLogInfo(event, nil, "complete")
+	return data, &meta, nil
+}
+
+func ReadDetailData(input e.ReadDetailDto, event *pl.Event, dbx ...*gorm.DB) (*e.DeathCause, error) {
+	pl.SetLogInfo(event, input, "started", "DBReadDetail")
+	data := e.DeathCause{}
+
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	if err := tx.First(&data, input.Id).Error; err != nil {
+		if processedErr := pu.HandleReadError(err, event, source, input.Id, data); processedErr != nil {
+			return nil, processedErr
+		}
+	}
+
+	pl.SetLogInfo(event, nil, "complete")
+	return &data, nil
+}
+
+func UpdateData(input e.UpdateDto, data *e.DeathCause, event *pl.Event, dbx ...*gorm.DB) error {
+	pl.SetLogInfo(event, data, "started", "DBUpdate")
+	setData(&input, data)
+
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	if err := tx.Save(&data).Error; err != nil {
+		event.Status = "failed"
+		event.ErrInfo = pl.ErrorInfo{
+			Code:   "data-update-fail",
+			Detail: "Database update failed",
+			Raw:    err,
+		}
+		return pl.SetLogError(event, input)
+	}
+
+	pl.SetLogInfo(event, nil, "complete")
+	return nil
+}
+
+func DeleteData(data *e.DeathCause, event *pl.Event, dbx ...*gorm.DB) error {
+	pl.SetLogInfo(event, data, "started", "DBDelete")
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	if err := tx.Delete(&data).Error; err != nil {
+		event.Status = "failed"
+		event.ErrInfo = pl.ErrorInfo{
+			Code:   "data-delete-fail",
+			Detail: "Database delete failed",
+			Raw:    err,
+		}
+		return pl.SetLogError(event, data)
+	}
+
+	pl.SetLogInfo(event, nil, "complete")
+	return nil
+}
diff --git a/internal/use-case/main-use-case/death-cause/middleware-runner.go b/internal/use-case/main-use-case/death-cause/middleware-runner.go
new file mode 100644
index 00000000..3b0b1aa0
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/middleware-runner.go
@@ -0,0 +1,103 @@
+package deathcause
+
+import (
+	e "simrs-vx/internal/domain/main-entities/death-cause"
+	pl "simrs-vx/pkg/logger"
+	pu "simrs-vx/pkg/use-case-helper"
+
+	"gorm.io/gorm"
+)
+
+type middlewareRunner struct {
+	Event  *pl.Event
+	Tx     *gorm.DB
+	MwType pu.MWType
+}
+
+// NewMiddlewareExecutor creates a new middleware executor
+func newMiddlewareRunner(event *pl.Event, tx *gorm.DB) *middlewareRunner {
+	return &middlewareRunner{
+		Event: event,
+		Tx:    tx,
+	}
+}
+
+// ExecuteCreateMiddleware executes create middleware
+func (me *middlewareRunner) RunCreateMiddleware(middlewares []createMw, input *e.CreateDto, data *e.DeathCause) error {
+	for _, middleware := range middlewares {
+		logData := pu.GetLogData(input, data)
+
+		pl.SetLogInfo(me.Event, logData, "started", middleware.Name)
+
+		if err := middleware.Func(input, data, me.Tx); err != nil {
+			return pu.HandleMiddlewareError(me.Event, string(me.MwType), middleware.Name, logData, err)
+		}
+
+		pl.SetLogInfo(me.Event, nil, "complete")
+	}
+	return nil
+}
+
+func (me *middlewareRunner) RunReadListMiddleware(middlewares []readListMw, input *e.ReadListDto, data *e.DeathCause) error {
+	for _, middleware := range middlewares {
+		logData := pu.GetLogData(input, data)
+
+		pl.SetLogInfo(me.Event, logData, "started", middleware.Name)
+
+		if err := middleware.Func(input, data, me.Tx); err != nil {
+			return pu.HandleMiddlewareError(me.Event, string(me.MwType), middleware.Name, logData, err)
+		}
+
+		pl.SetLogInfo(me.Event, nil, "complete")
+	}
+	return nil
+}
+
+func (me *middlewareRunner) RunReadDetailMiddleware(middlewares []readDetailMw, input *e.ReadDetailDto, data *e.DeathCause) error {
+	for _, middleware := range middlewares {
+		logData := pu.GetLogData(input, data)
+
+		pl.SetLogInfo(me.Event, logData, "started", middleware.Name)
+
+		if err := middleware.Func(input, data, me.Tx); err != nil {
+			return pu.HandleMiddlewareError(me.Event, string(me.MwType), middleware.Name, logData, err)
+		}
+
+		pl.SetLogInfo(me.Event, nil, "complete")
+	}
+	return nil
+}
+
+func (me *middlewareRunner) RunUpdateMiddleware(middlewares []readDetailMw, input *e.ReadDetailDto, data *e.DeathCause) error {
+	for _, middleware := range middlewares {
+		logData := pu.GetLogData(input, data)
+
+		pl.SetLogInfo(me.Event, logData, "started", middleware.Name)
+
+		if err := middleware.Func(input, data, me.Tx); err != nil {
+			return pu.HandleMiddlewareError(me.Event, string(me.MwType), middleware.Name, logData, err)
+		}
+
+		pl.SetLogInfo(me.Event, nil, "complete")
+	}
+	return nil
+}
+
+func (me *middlewareRunner) RunDeleteMiddleware(middlewares []readDetailMw, input *e.ReadDetailDto, data *e.DeathCause) error {
+	for _, middleware := range middlewares {
+		logData := pu.GetLogData(input, data)
+
+		pl.SetLogInfo(me.Event, logData, "started", middleware.Name)
+
+		if err := middleware.Func(input, data, me.Tx); err != nil {
+			return pu.HandleMiddlewareError(me.Event, string(me.MwType), middleware.Name, logData, err)
+		}
+
+		pl.SetLogInfo(me.Event, nil, "complete")
+	}
+	return nil
+}
+
+func (me *middlewareRunner) setMwType(mwType pu.MWType) {
+	me.MwType = mwType
+}
diff --git a/internal/use-case/main-use-case/death-cause/middleware.go b/internal/use-case/main-use-case/death-cause/middleware.go
new file mode 100644
index 00000000..845ec256
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/middleware.go
@@ -0,0 +1,9 @@
+package deathcause
+
+// example of middleware
+// func init() {
+// 	createPreMw = append(createPreMw,
+// 		CreateMw{Name: "modif-input", Func: pm.ModifInput},
+// 		CreateMw{Name: "check-data", Func: pm.CheckData},
+// 	)
+// }
diff --git a/internal/use-case/main-use-case/death-cause/tycovar.go b/internal/use-case/main-use-case/death-cause/tycovar.go
new file mode 100644
index 00000000..9cfe21a6
--- /dev/null
+++ b/internal/use-case/main-use-case/death-cause/tycovar.go
@@ -0,0 +1,44 @@
+/*
+DESCRIPTION:
+A sample, part of the package that contains type, constants, and/or variables.
+
+In this sample it also provides type and variable regarding the needs of the
+middleware to separate from main use-case which has the basic CRUD
+functionality. The purpose of this is to make the code more maintainable.
+*/
+package deathcause
+
+import (
+	"gorm.io/gorm"
+
+	e "simrs-vx/internal/domain/main-entities/death-cause"
+)
+
+type createMw struct {
+	Name string
+	Func func(input *e.CreateDto, data *e.DeathCause, tx *gorm.DB) error
+}
+
+type readListMw struct {
+	Name string
+	Func func(input *e.ReadListDto, data *e.DeathCause, tx *gorm.DB) error
+}
+
+type readDetailMw struct {
+	Name string
+	Func func(input *e.ReadDetailDto, data *e.DeathCause, tx *gorm.DB) error
+}
+
+type UpdateMw = readDetailMw
+type DeleteMw = readDetailMw
+
+var createPreMw []createMw      // preprocess middleware
+var createPostMw []createMw     // postprocess middleware
+var readListPreMw []readListMw  // ..
+var readListPostMw []readListMw // ..
+var readDetailPreMw []readDetailMw
+var readDetailPostMw []readDetailMw
+var updatePreMw []readDetailMw
+var updatePostMw []readDetailMw
+var deletePreMw []readDetailMw
+var deletePostMw []readDetailMw
diff --git a/internal/use-case/main-use-case/encounter/case.go b/internal/use-case/main-use-case/encounter/case.go
index fad183f6..43ce3cbf 100644
--- a/internal/use-case/main-use-case/encounter/case.go
+++ b/internal/use-case/main-use-case/encounter/case.go
@@ -2,10 +2,13 @@ package encounter
 
 import (
 	"errors"
+	"fmt"
+	uir "simrs-vx/internal/use-case/main-use-case/internal-reference"
 	"strconv"
 
 	ea "simrs-vx/internal/domain/main-entities/ambulatory"
 	ec "simrs-vx/internal/domain/main-entities/chemo"
+	edc "simrs-vx/internal/domain/main-entities/death-cause"
 	ee "simrs-vx/internal/domain/main-entities/emergency"
 	eem "simrs-vx/internal/domain/main-entities/employee"
 	e "simrs-vx/internal/domain/main-entities/encounter"
@@ -13,6 +16,7 @@ import (
 
 	ua "simrs-vx/internal/use-case/main-use-case/ambulatory"
 	uc "simrs-vx/internal/use-case/main-use-case/chemo"
+	udc "simrs-vx/internal/use-case/main-use-case/death-cause"
 	ue "simrs-vx/internal/use-case/main-use-case/emergency"
 	uem "simrs-vx/internal/use-case/main-use-case/employee"
 	ui "simrs-vx/internal/use-case/main-use-case/inpatient"
@@ -20,12 +24,12 @@ import (
 	erc "simrs-vx/internal/domain/references/common"
 	ere "simrs-vx/internal/domain/references/encounter"
 
-	dg "github.com/karincake/apem/db-gorm-pg"
-	d "github.com/karincake/dodol"
-
 	pl "simrs-vx/pkg/logger"
 	pu "simrs-vx/pkg/use-case-helper"
 
+	dg "github.com/karincake/apem/db-gorm-pg"
+	d "github.com/karincake/dodol"
+
 	"gorm.io/gorm"
 )
 
@@ -411,6 +415,66 @@ func CheckOut(input e.DischargeDto) (*d.Data, error) {
 			}
 		}
 
+		switch *input.Discharge_Method_Code {
+		case ere.DMCDeath:
+			// insert data death-cause
+			if _, err := udc.CreateData(edc.CreateDto{
+				Encounter_Id: &input.Id,
+				Value:        input.DeathCause,
+			}, &event, tx); err != nil {
+				return err
+			}
+
+		case ere.DMCConsulPoly, ere.DMCConsulExecutive:
+			unitIDs := make(map[uint16]struct{})
+			doctorIDs := make(map[uint]struct{})
+
+			for _, ref := range *input.InternalReferences {
+				if ref.Unit_Id != nil {
+					unitIDs[*ref.Unit_Id] = struct{}{}
+				}
+				if ref.Doctor_Id != nil {
+					doctorIDs[*ref.Doctor_Id] = struct{}{}
+				}
+			}
+
+			// validate unitIds
+			if len(unitIDs) > 0 {
+				var ids []uint16
+				for id := range unitIDs {
+					ids = append(ids, id)
+				}
+
+				units, err := getUnits(ids, &event, tx)
+				if err != nil {
+					return fmt.Errorf("failed to fetch units: %w", err)
+				}
+				if len(units) != len(ids) {
+					return fmt.Errorf("some unit_id not found")
+				}
+			}
+
+			// validate doctorIds
+			if len(doctorIDs) > 0 {
+				var ids []uint
+				for id := range doctorIDs {
+					ids = append(ids, id)
+				}
+
+				doctors, err := getDoctors(ids, &event, tx)
+				if err != nil {
+					return fmt.Errorf("failed to fetch doctors: %w", err)
+				}
+				if len(doctors) != len(ids) {
+					return fmt.Errorf("some doctor_id not found")
+				}
+			}
+
+			if err := uir.CreateBulkData(*input.InternalReferences, input.Id, &event, tx); err != nil {
+				return err
+			}
+		}
+
 		pl.SetLogInfo(&event, nil, "complete")
 
 		return nil
diff --git a/internal/use-case/main-use-case/encounter/helper.go b/internal/use-case/main-use-case/encounter/helper.go
index 7cb72938..36244f83 100644
--- a/internal/use-case/main-use-case/encounter/helper.go
+++ b/internal/use-case/main-use-case/encounter/helper.go
@@ -8,6 +8,7 @@ import (
 	"errors"
 	"fmt"
 	"strings"
+	"time"
 
 	"gorm.io/gorm"
 
@@ -15,6 +16,7 @@ import (
 	pu "simrs-vx/pkg/use-case-helper"
 
 	edo "simrs-vx/internal/domain/main-entities/device-order"
+	ed "simrs-vx/internal/domain/main-entities/doctor"
 	emo "simrs-vx/internal/domain/main-entities/material-order"
 	emco "simrs-vx/internal/domain/main-entities/mcu-order"
 	em "simrs-vx/internal/domain/main-entities/medication"
@@ -23,6 +25,7 @@ import (
 	emmi "simrs-vx/internal/domain/main-entities/medicine-mix-item"
 	ep "simrs-vx/internal/domain/main-entities/prescription"
 	epi "simrs-vx/internal/domain/main-entities/prescription-item"
+	eu "simrs-vx/internal/domain/main-entities/unit"
 
 	// udo "simrs-vx/internal/use-case/main-use-case/device-order"
 	es "simrs-vx/internal/domain/main-entities/soapi"
@@ -77,12 +80,15 @@ func setDataUpdate(src e.UpdateDto, dst *e.Encounter) {
 }
 
 func setDataDischarge(src e.DischargeDto, dst *e.Encounter) {
-	dst.DischargeMethod_Code = src.DischargeMethod_Code
+	dst.Discharge_Method_Code = src.Discharge_Method_Code
 	dst.EarlyEducation = src.EarlyEducation
 	dst.MedicalDischargeEducation = src.MedicalDischargeEducation
 	dst.AdmDischargeEducation = src.AdmDischargeEducation
 	dst.DischargeReason = src.DischargeReason
 	dst.Status_Code = erc.DSCDone
+
+	now := time.Now()
+	dst.Discharge_Date = &now
 }
 
 func checkSoapiByDocExists(encounter_id uint, event *pl.Event, tx *gorm.DB) error {
@@ -317,3 +323,35 @@ func getMcuOrders(encounter_id uint, event *pl.Event, tx *gorm.DB) error {
 func setDataUpdateStatus(src e.UpdateStatusDto, dst *e.Encounter) {
 	dst.Status_Code = src.StatusCode
 }
+
+func getUnits(unitIds []uint16, event *pl.Event, tx *gorm.DB) ([]eu.Unit, error) {
+	pl.SetLogInfo(event, nil, "started", "getUnits")
+	var units []eu.Unit
+	err := tx.Where("\"Id\" IN ?", unitIds).Find(&units).Error
+	if err != nil {
+		event.Status = "failed"
+		event.ErrInfo = pl.ErrorInfo{
+			Code:   "data-get-fail",
+			Detail: "get units",
+			Raw:    err,
+		}
+		return nil, pl.SetLogError(event, nil)
+	}
+	return units, nil
+}
+
+func getDoctors(doctorIds []uint, event *pl.Event, tx *gorm.DB) ([]ed.Doctor, error) {
+	pl.SetLogInfo(event, nil, "started", "getDoctors")
+	var doctors []ed.Doctor
+	err := tx.Where("\"Id\" IN ?", doctorIds).Find(&doctors).Error
+	if err != nil {
+		event.Status = "failed"
+		event.ErrInfo = pl.ErrorInfo{
+			Code:   "data-get-fail",
+			Detail: "get doctors",
+			Raw:    err,
+		}
+		return nil, pl.SetLogError(event, nil)
+	}
+	return doctors, nil
+}
diff --git a/internal/use-case/main-use-case/internal-reference/case.go b/internal/use-case/main-use-case/internal-reference/case.go
index 1681bf26..bfd9550f 100644
--- a/internal/use-case/main-use-case/internal-reference/case.go
+++ b/internal/use-case/main-use-case/internal-reference/case.go
@@ -1,19 +1,9 @@
 package internal_reference
 
 import (
-
-	// main entities
-	ed "simrs-vx/internal/domain/main-entities/doctor"
-	ee "simrs-vx/internal/domain/main-entities/encounter"
 	eir "simrs-vx/internal/domain/main-entities/internal-reference"
-	eu "simrs-vx/internal/domain/main-entities/unit"
 	"strconv"
 
-	// main use case
-	ud "simrs-vx/internal/use-case/main-use-case/doctor"
-	ue "simrs-vx/internal/use-case/main-use-case/encounter"
-	uu "simrs-vx/internal/use-case/main-use-case/unit"
-
 	pl "simrs-vx/pkg/logger"
 	pu "simrs-vx/pkg/use-case-helper"
 
@@ -43,11 +33,6 @@ func Create(input eir.CreateDto) (*d.Data, error) {
 			return err
 		}
 
-		// Validate Request
-		if err := validateRequest(input); err != nil {
-			return err
-		}
-
 		if resData, err := CreateData(input, &event, tx); err != nil {
 			return err
 		} else {
@@ -179,29 +164,6 @@ func ReadDetail(input eir.ReadDetailDto) (*d.Data, error) {
 	}, nil
 }
 
-func validateRequest(input eir.CreateDto) (err error) {
-
-	// Validate Encounter Id
-	_, err = ue.ReadDetail(ee.ReadDetailDto{Id: uint16(*input.Encounter_Id)})
-	if err != nil {
-		return err
-	}
-
-	// Validate Unit Id
-	_, err = uu.ReadDetail(eu.ReadDetailDto{Id: *input.Unit_Id})
-	if err != nil {
-		return err
-	}
-
-	// Validate Doctor Id
-	_, err = ud.ReadDetail(ed.ReadDetailDto{Id: uint16(*input.Doctor_Id)})
-	if err != nil {
-		return err
-	}
-
-	return
-}
-
 func Update(input eir.UpdateDto) (*d.Data, error) {
 	rdDto := eir.ReadDetailDto{Id: input.Id}
 	var data *eir.InternalReference
@@ -228,21 +190,10 @@ func Update(input eir.UpdateDto) (*d.Data, error) {
 			return err
 		}
 
-		// Validate Request
-		if err := validateRequest(input.CreateDto); err != nil {
-			return err
-		}
-
 		if err := UpdateData(input, data, &event, tx); err != nil {
 			return err
 		}
 
-		// Get Updated Data
-		rdDto.Includes = "encounter,unit,doctor"
-		if data, err = ReadDetailData(rdDto, &event, tx); err != nil {
-			return err
-		}
-
 		pl.SetLogInfo(&event, nil, "complete")
 
 		mwRunner.setMwType(pu.MWTPost)
diff --git a/internal/use-case/main-use-case/internal-reference/helper.go b/internal/use-case/main-use-case/internal-reference/helper.go
index aaef382a..dbd92f73 100644
--- a/internal/use-case/main-use-case/internal-reference/helper.go
+++ b/internal/use-case/main-use-case/internal-reference/helper.go
@@ -21,3 +21,17 @@ func setData[T *ir.CreateDto | *ir.UpdateDto](input T, data *ir.InternalReferenc
 	data.Unit_Id = inputSrc.Unit_Id
 	data.Doctor_Id = inputSrc.Doctor_Id
 }
+
+func setBulkData(input []ir.CreateDto, encounterId uint) []ir.InternalReference {
+	var data []ir.InternalReference
+
+	for _, v := range input {
+		data = append(data, ir.InternalReference{
+			Encounter_Id: &encounterId,
+			Unit_Id:      v.Unit_Id,
+			Doctor_Id:    v.Doctor_Id,
+		})
+	}
+
+	return data
+}
diff --git a/internal/use-case/main-use-case/internal-reference/lib.go b/internal/use-case/main-use-case/internal-reference/lib.go
index a50d594c..18215078 100644
--- a/internal/use-case/main-use-case/internal-reference/lib.go
+++ b/internal/use-case/main-use-case/internal-reference/lib.go
@@ -142,3 +142,24 @@ func DeleteData(data *eir.InternalReference, event *pl.Event, dbx ...*gorm.DB) e
 	pl.SetLogInfo(event, nil, "complete")
 	return nil
 }
+
+func CreateBulkData(input []eir.CreateDto, encounterId uint, event *pl.Event, dbx ...*gorm.DB) error {
+	pl.SetLogInfo(event, nil, "started", "DBCreate")
+
+	data := []eir.InternalReference{}
+	setBulkData(input, encounterId)
+
+	var tx *gorm.DB
+	if len(dbx) > 0 {
+		tx = dbx[0]
+	} else {
+		tx = dg.I
+	}
+
+	if err := tx.Create(&data).Error; err != nil {
+		return plh.HandleCreateError(input, event, err)
+	}
+
+	pl.SetLogInfo(event, nil, "complete")
+	return nil
+}