FINAL PROPOSAL FOR

KERALA MEDICO-LEGAL CODE

Prepared by
Dr. P. B. GUJARAL
President, Kerala Medico - Legal Society
Senior Consultant in Forensic Medicine &
District Police Surgeon, Palakkad.

MODIFIED ACCORDING TO

THE SUGGESTIONS OF THE TWO DAY WORKSHOP

HELD AT
STATE MEDICO-LEGAL INSTITUTE, THIRUVANANTHAPURAM, ON
28TH AND 29TH OF APRIL 2010
&
THE DIRECTIONS OF KERALA JUDICIAL ACADEMY
HIGH COURT OF KERALA, KOCHI

SUBMITTED TO

GOVERNMENT OF KERALA
BY

KERALA MEDICO-LEGAL SOCIETY

(Organization of Police Surgeons & Medico-legal experts in Kerala)
 INTRODUCTION
THE NEED FOR A CODE OF MEDICO-LEGAL EXAMINATION AND

CERTIFICATION
 Factors which necessitate modifications in the present formats for
Medico-legal Examination and Certification and Implementation of a Code of
Medico-legal Examination and Certification
 The formats for medico-legal certificates were designed in the sixties and last
modified in the Eighties (1984) of the previous century and it is high time that the
existing formats are modified for the benefit of Law, the Public and also the
Medical Officers who dutifully document such certificates. The process of
updating the medico-legal system through Government Orders came to a stand-
still in 1986, in Kerala. The last circular in this regard seems to be
No18023/H1/86 dated 04-09-86 regarding time limit of postmortem examinations
and the last G.O. seems to be G.O. MS. 207/86/Home (H) dated 22-09-1986,
regarding designation of Police Surgeons, both from the Home Department.
 The 2006 amendments made to the Criminal Procedure Code, especially in
relation to Sections 53 and 54 and the Common Order from the honorable High
court of Kerala dated 05-08-2009 warrants immediate implementation of specific
guidelines for medico-legal examination and certification in the state and
modification of the existing system.
 It is a plain fact that, except a few senior faculties in the Departments of Forensic
Medicine in Government Medical Colleges, nobody is aware of the latest G.O.
issued in this regard. As per G.O. (MS) 122/84/Home, TVM dated 04-09-84,
Government approved the guidelines and model forms for medico-legal
examination and certification, prepared by Dr. V.K.Jayapalan, the then Director
and Professor of Forensic Medicine, Medical College, Trivandrum and the same
is in force now. Till recently, the copy of this G.O. was only available at Forensic
Medicine Departments of one or two Medical Colleges. In all Institutions under
Health Services Department, the G.O. issued in the sixties is being followed. It is
so outdated that, it prescribes recording of the postmortem certificate using
carbon pencil, so that copies can be made using carbon paper.
 Many changes have occurred in the concepts of Law enforcement, Human
Rights and interpretation of the Law by Judiciary in the last twenty five years.
 The number of medico-legal cases increased manifold.
 Earlier, it was only Government Hospitals that were used to undertake medico-
legal examinations and certifications. With a Supreme Court Order, it was made
 mandatory that every doctor practicing Modern Medicine should attend the
injured and institute proper and adequate treatment and fulfill his medico-legal
responsibilities, within the capacity of the doctor and the institution to which he is
attached. The same principle became applicable in the cases of female victim of
sexual assault, on the basis of another Order from the Supreme Court. Most of
the private institutions also, are undertaking medico-legal work now.
 Apart from the requirements of the Law and the Law Enforcing System, the rights
of the affected person(s) in every Medico-legal case should be considered.
Requirements in relation to the concepts of Human Rights, incessant growth of
the field of Insurance and of late, the Right to Information Act etc should also be
considered.
 The doctor who first examine or admit a patient in the casualty / OP may not be
the one who treats the patient. In contrast to the practice followed till the
Seventies, the admitting doctor may not be seeing the patient again, during the
course of treatment or at the time of discharge. The doctor, who actually treated
the patient, will be writing the Discharge Certificate. During the trial of the case in
Court of Law, questions are raised to doctors, for not filling the columns in the
wound certificate, in relation to results of laboratory and other investigations,
details of treatment, condition at discharge etc. Also, on many occasions, doctors
find it difficult to answer the questions in relation to the abovementioned aspects,
with the very little data recorded in the present format of Discharge Certificate,
which is prescribed by G.O. (MS) 122/84/Home, TVM dated 04-09-84, mentioned
earlier. Instances are many, when doctors are asked to reappear before the
Hon’ble Court, with the entire case sheet, on a later date. Hence, the system of
just one wound certificate to incorporate the findings at admission, investigation
results, treatment details and condition at discharge etc became impractical.
What is needed is a comprehensive format for recording the Discharge
Certificate, for patients admitted with a Medico-legal case history. The Discharge
certificate format prescribed in the 1984 G.O. is insufficient for this purpose and
needs thorough modification.
 The space available in the present format of wound certificate, for recording the
injuries, is very limited. Bifurcation of the treatment and discharge part from the
wound certificate will reduce the columns in the present format and will enhance
 the space for recording the injuries. A proper, elaborate and scientific recording
of the injuries will definitely help the Judiciary and the Police in ensuring justice to
the injured and will also help the doctor to substantiate his findings in spite of
severe cross examination by the defense.
 When an injured person is brought to a hospital, he has every right to get a copy
of the wound certificate. Now that, almost everyone is having one or other
Insurance coverage, the need for such a copy is very much pressing, as far as
the injured is concerned. Presently, the wound certificate is written only in
duplicate. Original is issued to the Investigating police officer and the duplicate
retained as office copy. To fulfill the legal right of the injured, the wound
certificate should be written in triplicate and one copy should be issued to him or
his legal heirs on demand for the same.
 Every doctor, qualified in Modern Medicine, should know how to classify the
injuries examined by him, as hurt and grievous hurt. It is based on this
interpretation that the relevant sections of IPC are incorporated by the
Investigating Officer, in the charge sheet against the accused. It will be fair
enough to record this interpretation in the opinion part of the wound certificate,
instead of giving the same in the statement given to Investigating Officer, as is
being practiced now. In cases where findings revealed by investigations such as
X-ray examination etc., during the course of treatment by another doctor in the
same institution or another institution, make the injury grievous, that has to be
recorded in the discharge certificate.
 There is a lack of awareness among doctors, regarding their legal
responsibilities. Intimation is the first legal responsibility that every doctor
practicing Modern Medicine, should fulfill. In all instances, where a patient or
persons who brought the patient to the doctor, gives a history of any unlawful act
punishable under any sections of Indian Penal Code and if the doctor or the
patient or the persons who brought the patient to the doctor has reasons to
believe that the particular unlawful act has actually caused or contributed in the
causation of the condition which made the patient to approach the doctor or
made someone to take the patient to doctor, the doctor is legally bound to
intimate the police, about the particular unlawful act. This should be done
immediately when such a fact is brought to the notice of the doctor, during any
 phase of interaction between the patient and the doctor, as part of a doctor-
patient relationship. Any offence under the purview of I.P.C. is considered as an
offence against the State. During the trial of such cases in the Court of Law, the
State represented by the Government Prosecutors or Pleaders, acts as the
complainant. Hence, the doctor need not take the consent of the injured or the
victim of unlawful act, for giving intimation to police. Ignorance of this aspect has
made many doctors to face serious legal consequences.
 Such deficiencies and lacunae exist with all the Medico-legal examinations and
certifications.
 The Drunkenness Certificate, with a spelling mistake (Drunkness) in its heading
itself, is a classical example. From a legal viewpoint, examination of any person
without his consent is an assault. And, there is no column for consent in the
present format of certification of drunkenness. There is no column for recording
any history available from the subject, in relation to consumption of alcohol. In
the examination of a person to look for drunkenness, the cardinal sign looked for
consumption is smell of alcohol in breath. The ceiling or other fans should be
switched off, and the examiner should be able to identify the smell of alcohol in
the breath of the subject, from a distance of 30cm. The smell should be
persistent, that is, it should be present in the beginning of the examination and
also at the end. If present, opinion that the person has consumed alcohol is
furnished. If the higher functions like memory, muscular coordination, reflexes etc
are involved, an opinion that the person is under the influence of alcohol is
furnished. By just going through the present format, it can very well be seen that
there is no scope for a schematic examination with an objective of obtaining a
defined and qualified opinion regarding drunkenness. Above all, it contains such
ridiculous tests like asking the person to light a cigarette, as part of the
examination. There is no defined opinion part, which if present, will be of great
assistance to the doctor as well as the Law.
 In cases of drunkenness also, the relevant section of Kerala Police Act can be
incorporated in the charge sheet, only on the basis of the opinion furnished by
the doctor. Hence, it is ideal that the certificate is issued immediately or at the
earliest within 24hours of the examination.
 Also, doctors are generally unaware of the relevance of preservation of blood
and urine samples in cases of alleged drunkenness. When a person is brought
for examination with a history of alleged drunken, disorderly behavior in a public
place, punishable under Sec.51(a) of Kerala Police Act, blood and urine
examination is not mandatory. In cases of alleged drunken driving, punishable
under Sec.185 of Motor Vehicle Act (1988, last amended in 1994), it should be
proved that there was presence of alcohol in the blood of the suspect, in excess
of 30mg/100ml. Hence, blood and urine examination is mandatory in such cases.
Just because blood and urine samples were not preserved in such cases,
persons accused of that offence is always acquitted in the Courts.
 The presently followed formats for examination and certification of Potency and
that for examination and certification of a female victim of Sexual Offences are
not available in most of the institutions undertaking such examinations. The
prescribed method of recording the findings in a draft format and preparing and
issuing the certificate in another format is highly impractical. It is a fact that in
many institutions, these certificates are recorded in the Accident Register Cum
Wound Certificate. This method is highly improper because it will lead to
insufficient documentation and loss of confidentiality. With the 2006
amendments, it becomes necessary that a comprehensive format conforming to
the requirements stipulated in Sec 53A of Cr.P.C. is designed.
 The present format for examination and certification of Potency is spread over
two pages, which makes recording in duplicate, using carbon paper difficult. If it
can be reduced to one page, it can be maintained in a book form.
 The concepts relating to sexual offences, including rape, has changed to the core
in recent years. The present format and the opinion part in the certificate of
examination of a female victim of sexual offence is of relevance to cases
reported immediately or at the most within a few days of occurrence of such an
offence. In practice, it is seen that such cases are reported after many weeks or
months. The format should be modified to incorporate that aspect also.
 With the advent of DNA fingerprinting, it became necessary to preserve
specimens for that purpose also. A second sample of properly preserved vaginal
swab will serve this purpose.
 New areas like examination of a male victim of unnatural sexual offences,
examination and certification of a victim alleged to have been drugged or sedated
for the purpose of theft or other such unlawful acts, medical examination of a
person before admission to a jail, examination of an accused/subject by a Team
of Experts etc are arising where medico-legal certification is mandatory, but we
don’t have any prescribed formats in all institutions. Generally doctors are
unaware of the proper scheme of examination in such cases and also about the
material objects that are to be preserved in each type of such cases. What is
being done now is that they record the history and findings of general physical
examination in the Accident Register cum Wound Certificate. With the
amendment made to Sec.54 Cr.P.C., the accused is entitled to have a copy of
the certificate of physical examination of his body. That necessitate the recording
of almost every medico-legal certificate in triplicate.
 Doctors working in the busy Casualty units of a Medical College or District
Hospital and Doctors who are managing the peripheral institutions find it difficult
to document the irrelevant and unnecessary data to be filled in the present
formats, which in turn leads to loss of time from their duty hours.
 Absence of defined data regarding the findings, opinions and interpretations in
the present formats lead to lack of uniformity in Medico-legal documentation
throughout the state.
 These problems often render the Doctor incapable of substantiating his findings,
opinions and interpretations in the Court of Law, which makes all the effort taken
in this regard worthless and leads to great loss of Government money.
 Only less than three percent of the total Medico-legal examination and
certification is being done by qualified Forensic Medicine specialists. More than
97% of the medico-legal certification is done by M.B.B.S. doctors and doctors
from specialties other than Forensic Medicine, working in Health Services
Department, Government Medical Colleges and Private Hospitals in our State.
Major share of Medico-legal work (about three fourth) is undertaken by the
doctors of Health Services Department, in comparison to those working in the
Medical Colleges and Private institutions. The above said problems mainly affect
doctors in Health Services Department.
 It is a fact that there is a dearth of doctors in the Health Services Department.
Among the many factors that keep doctors away from Government Sector, one
important factor is an aversion caused by fear, among doctors, towards handling
medico-legal cases and their invariable, delayed consequence of Court
appearance. This fact is clearly evidenced by the intense scarcity of doctors to
work in Casualty Units of Institutions with a secondary or tertiary status, under
Health Services Department. By making examination, recording of findings and
their interpretation in medico-legal cases easy and giving adequate training to
handle such cases and also on how to give evidence in a Court of Law, this
problem can be solved.
 Doctors working in many institutions under Health Services Department are not
getting the existing formats for certification. In many institutions doctors keep one
copy of the format and get a photocopy of that format for certification every time.
There are no specific guidelines to ensure uninterrupted supply of the medico-
legal formats to the Medical Officers.
 There are no specific guidelines regarding the issue of medico-legal certificates
(who should issue, to whom should issue, when should issue etc). Also
instructions regarding the institution-wise custodianship of such documents are
lacking.
 There are no specific guidelines regarding the category-wise responsibility for
undertaking various medico-legal examinations. Specific guidelines are lacking
with regard to which category of doctors should undertake what type of medico-
legal examinations.
 There is also lack of awareness regarding the category of doctors authorized to
do an autopsy. As per G.O. MS No.364/68/Home, dated 14-10-1968, from the
Home (A) Department, Trivandrum, it is stated that the Police Surgeons will
conduct all medico-legal autopsies in the Hospital to which he is attached. This
can very well be taken to be in accordance with the specification namely,
qualified medical man appointed in this behalf (autopsy) by the State
Government, mentioned in subsection (v) of clause (3) of Sec.174, Cr.P.C. This
may be one reason why all cases for postmortem examination with inquest by
Executive Magistrate is being forwarded to the Police Surgeons on all possible
occasions. In the same order from the Home Department, it is stated that all
 cases of homicides, suspicious deaths, traffic accidents and other important
cases should be personally attended to by the Police Surgeons. Except in cases
of Traffic accidents, this is being followed even now. There is a reference to
routine cases of postmortem examination to be attended by Medical Officers
other than Police Surgeons, in G.O. Rt. No.1985/84/HD dated 19-6-1984, from
the Health (A) Department, Trivandrum. Then there is the Order, G.O. (Rt)
No.1185/82/Home, dated Trivandrum 3-5-82, which authorize postgraduate
students in the Department of Forensic Medicine in the State, to undertake
medicolegal work including autopsy, independently. From all these, a reasonable
presumption that all Police Surgeons, Medical Officers under Health Services
and Medical Education Departments are authorized to do autopsy, apart from the
Post Graduate Students in Forensic Medicine department of Medical Colleges.
Also there are the recent Government Orders authorising Co-operative Medical
College, Pariyaram and Amrutha Institute of Medical Sciences, Kochi, to
undertake Medico-legal autopsy.
 Another area of controversy is regarding the time of postmortem examinations.
As per the provisions of Sec.174 and 176 of Cr.P.C., and based on circulars from
the Central Government and verdicts form the Hon’ble Supreme Court {
Bhupinder Singh v. State of Panjab, (1988) 2 SCJ 246 (SC) } postmortem
examination is a mandatory legal procedure to be followed in all cases of death
due to unnatural causes. It is a universally accepted dictum that, ideally
postmortem examination should be conducted in broad day light and hence, the
time for conducting postmortem examination was fixed as between 07.00am and
05.00pm. Since a complete medico-legal postmortem examination will take a
minimum of one hour, it was further clarified by the Government that medical
officers shall not accept requisitions for postmortem examination after 04.00pm.
In spite of these directives, there were instances where medical officers were
compelled to accept requisitions for postmortem examinations after 0.400pm.
The Government then further issued a circular (No.18023 / H 1 / 86 / Home (H)
Department, TVM Dated 04-09-1986), instructing the District Collectors, Revenue
Divisional Officers, Superintendents of Police and other such officers, not to
compel medical officers to undertake postmortem examinations, after the
 prescribed time limit. These are the three existing Government Orders /
Circulars, regarding the time of postmortem examination.
 According to the destination of the postmortem certificates and where the
processing according to the provisions of the Law (Indian Penal Code and
Criminal Procedure Code) and consequent final disposal of the case is done,
these certificates can generally be divided into two categories. All cases of
unnatural deaths, where any of the sections of I.P.C. is not applicable, will be
disposed off by the Executive Magistrates. All cases where any of the sections of
I.P.C. is applicable, will be dealt with by the Judicial Courts of Law. For any of
such certificates to be admissible in the Court of Law, they should be according
to the Law, as per the rules and prepared and issued in order. Even minute
technical flaws in the conduct of the prescribed procedure, preparation and issue
of the certificate or any of such aspects may be challenged by the defense or
may render such certificate inadmissible in the Court of Law. From a legal
viewpoint, it is not at all desirable that someone is authorized to violate or instruct
someone to violate the existing rules for any reason, without concurrence from
the Hon’ble Court of Law or a decision by the Government, changing such rules.
Another important point is that, nobody can predict which case of unnatural death
without any obvious implications of any sections of I.P.C. at the outset, may later
become a case to be dealt with by a Judicial Court. It may be during the course
of investigation that the case becomes one with sections like 302, 304, 304(A),
304(B), 306, 314, 315, 316, 376, 377 or 498-A of I.P.C. is attributable to it.
Hence, it is ideal that the postmortem examinations are done according to the
Law, as per the rules, in order and without any interference from any person or
agency. It is to be born in mind that, such directions from any superior officer, to
violate any existing rule regarding postmortem examination and the medical
officer acting in compliance with such directions, may create room for doubt
regarding the findings and conclusions recorded in the certificate. Such actions
are not definitely going to be interpreted as the one being done in the interest of
Justice and may get interpreted as an interference with the process of Law.
During the trial of the case in a Court of Law, the medical officer alone will have
to answer for such technical flaws, committed by him under pressure or on order
from the superior officer.
 With the advent of Private Insurance Companies, the importance of such
technicalities assumed new dimensions. Most of the schemes of these
companies deprive compensation to the legal heirs of the insured, in the event of
accidental death of the insured, if it can be proved that there was any factor of
any sort, contributed from the part of the deceased, in the causation of death. It is
seen that these companies make their own investigation into every such death,
with a view to find out any of such factors. Any influence which caused a violation
of Law or Rules, may be taken advantage of, and may result in deprivation of the
otherwise entitled compensation to the legal heirs of the deceased. There is lack
of clarity in understanding these aspects among medical officers and most often
they fail to convince the superior officers, the problem in complying to the
instructions given to them on the basis of public demand.
 From all these it becomes clear that the Government has the absolute authority
in laying down the rules regarding the time of postmortem examination. But once
the Government has laid down such rules and issued a Government Order in this
behalf, it is undesirable for any officer or agency, other than the Government, to
compel any medical officer to violate such rules, on any reason.
 Medico-legal postmortem examination is a strictly legal affair and the medical
officer who has conducted such postmortem examination shall not communicate
with anyone other than the Investigating Officer and the Executive or judicial
Magistrate, regarding the findings of such examination, without permission from
the Investigating Officer or the Magistrate. Such communications should be
according to any of the provisions of the I.P.C., Cr.P.C. or Indian Evidence Act.
Nowadays, it has become very common that the private detectives employed by
the private Insurance companies approaching medical officers, asking for a
statement regarding the manner of death, findings, results of chemical and other
such analysis etc. Most of the medical officers are unaware of the fact that they
are not entitled to give such statements, which are not within the purview of the
three codes of Law, mentioned earlier. What they can do is to certify the
authenticity of the certificate of postmortem examination issued by them.
 There are also gray areas like typewriting the postmortem certificates,
custodianship of a dead body kept for postmortem examination, maximum period
up to which viscera and other material objects preserved from a medico-legal
 case should be preserved in the event of not being forwarded to Chemical
Examiner immediately, maximum period up to which medico-legal documents are
to be kept in an institution etc where no specific guidelines are still lacking.
All these and other such deficiencies necessitate the evolution of a Code of
Medico-legal Examination and Certification, applicable to the entire State, in the
form of a Government Order and the ideal name for such code will be KERALA
MEDICO-LEGAL CODE.
Such a Code of Medico-legal Examination & Certification, should contain
specific regulations regarding the
 Classification of different Medico-legal examinations
 Formats to be used for each type examination.
 Size and the minimum available writing space of each certificate.
 Responsibility of printing the certificates and ensuring their availability to
doctors.
 Category of institutions/doctors who should undertake each type of
examination.
 Conduct of every medico-legal examination.
 Recording the Medico-legal certificates.
 Maintenance and issue of these documents.
The formats should be easy to be filled in, with findings and opinion
incorporated in “choose the correct one and strike off the others” manner, in all
possible instances. The code of medico-legal examination and certification with
instructions regarding the documentation, maintenance and issue of such
certificates, should be made available to all doctors working in Health Services,
Medical Education Department and Private Hospitals. This can be achieved by
publishing the Code in the official website of Health & Family Welfare Department,
from where all doctors can download the same. Institutions can make arrangements
for the printing of the formats based on the samples downloaded. Regular training
should be ensured to all doctors on Medico-legal examination and documentation,
on an yearly basis. This should be arranged through the District Medical Officers of
every District, with the help of qualified Forensic Medicine Specialists in Medical
Education and Health Services Departments.
KERALA MEDICO-LEGAL CODE
 KERALA MEDICO-LEGAL CODE

A. Introduction : This code of medico-legal examination and certification prescribes the

procedures to be followed in the conduct of each and every medico-legal examinations,
various formats to be used for the purpose of medico-legal examination and certification
and the guidelines for their maintenance, documentation, issue and the supply of
documents and allied materials and facilities necessary for the process. The code is to
be followed for making the process of medico-legal examination and certification
uniform throughout the state and is applicable to all Registered Medical Practitioners, in
Government, Co-operative and Private sectors.
As per clause (b) of part 2 of Section 53 of Criminal Procedure Code, a registered
medical practitioner means a medical practitioner who possess any medical qualification
as defined in clause (h) of section 2 of the Indian Medical Council Act, 1956(102 of
1956) and whose name has been entered in a State Medical Council.
This code is formulated on the basis of the six legal responsibilities which every
doctor practicing Modern Medicine should fulfill (viz Intimation, Documentation,
Preservation of Evidence, Consultation, Dying Declaration and Death Intimation), the
rights of the injured person(s) as well as that of accused person(s) and the verdicts,
comments and observations of the Apex Court of the Country. All previous Orders of
The Government of Kerala in this regard were also taken in to consideration, in the
formulation of this code. The code is also updated in par with the amendments (2006) to
Sec.53, 53A, 54, 54A of Criminal Procedure code and the Common Order of the
Honorable High Court of Kerala, dated 05-08-2009 in this regard.
Whatever is contained in this Code will be the foundation for the general conduct of
any medico-legal examination. Considering the fact that every medico-legal examination
is unique in one or other way, qualified medico-legal experts including Police Surgeons
will have the right to add to or modify the prescribed procedures and the formats for
medico-legal certification, according to nature and peculiarity of every case.
B. Medico-legal Examinations : The code identifies the following as Medico-legal
Examinations & Certifications :-
1) Wound certification.
2) Examination and Certification of Drunkenness.
3) Examination and Certification of a male accused in sexual offence, including the
examination of his potency.
4) Examination and Certification of a female victim of Sexual Assault.
5) Examination and Certification of a victim of Unnatural Sexual Offence.
6) Examination and certification of a female to look for signs of recent delivery.
7) Examination and Certification of a victim alleged to have been drugged.
8) Certificate of Physical Examination of any person, by a Medical Officer, on the
written requisition from a Judicial or Police Officer.
9) Certificate of Physical Examination of any person, by a Specialist Medical Officer or
Team of Specialist Medical Officers, on the written requisition from a Judicial or
Police Officer.
10) Certification of age.
11) Postmortem Examination.
12) And any other medical examination of a person, conducted by a registered medical
practitioner defined as per clause (b) part 2 of section 53 Cr.P.C., for the purpose of
identifying or excluding findings or collection of material objects which may aid in the
administration of justice
C. Medico-legal and allied Certificates and Registers : There should be all or
necessary of the following medico-legal and allied certificates and the registers for use
in institutions undertaking medico-legal work, as will be specified below.
1) Accident Register cum Wound Certificate – in a book form with Original (perforated
to make detachable) for issuing to the Police/Judicial authorities, duplicate
(perforated to make detachable) for issuing to the injured person or to person
nominated by the injured person and triplicate to be retained as office copy.
2) Police intimation – in a book form with Original (perforated to make detachable) for
issuing to the Police Officer and duplicate to be retained as office copy.
3) Proforma for recording Dying Declaration by a Registered Medical Practitioner – in
a book form with Original (perforated to make detachable) for issuing to the
Police/Judicial authorities and duplicate to be retained as office copy.
4) Treatment / Discharge Certificate in continuation to Wound Certificate - in a book
form with Original (perforated to make detachable) for issuing to the Police/Judicial
authorities, duplicate (perforated to make detachable) for issuing to the injured
 person or to person nominated by the injured person and triplicate to be retained
as office copy.
5) Certificate of Drunkenness - in a book form with Original (perforated to make
detachable) for issuing to the Police Officer and duplicate (perforated to make
detachable) to be issued to the person examined or a person nominated by him
when the examination is conducted as per the provisions of Sec.54 of Cr.P.C. and
triplicate copy to be retained as office copy.
6) Medico-legal Register – for recording the details of medico-legal examinations,
other than wound certifications, drunkenness certifications and postmortem
examinations so as to assign serial ML.No. (Medico-legal Examination Number) to
every such examination, in a calendar year-wise manner.
7) Report of examination of a male accused in sexual offence, including the
examination of his potency - in a book form with Original (perforated to make
detachable) for issuing to the Judicial / Police Officer, duplicate (perforated to
make detachable) to be issued to the person examined or a person nominated by
him when the examination is conducted as per the provisions of Sec.54 of Cr.P.C.
and triplicate to be retained as office copy.
8) Report of examination of a female victim of Sexual Assault - in a book form with
Original (perforated to make detachable) for issuing to the Judicial / Police Officer
and duplicate(perforated to make detachable) to be issued to the victim or the
person nominated by the victim and the triplicate to be retained as office copy.
9) Report of examination of a victim of Unnatural Sexual Offence - in a book form with
Original (perforated to make detachable) for issuing to the Police Officer and
duplicate (perforated to make detachable) to be issued to the victim or the person
nominated by the victim and the triplicate to be retained as office copy.
10) Report of examination of a female for signs of recent delivery - in a book form with
Original (perforated to make detachable) for issuing to the Police Officer and
duplicate (perforated to make detachable) to be issued to the female examined or
a person nominated by her when the examination is conducted as per the
provisions of Sec.54 of Cr.P.C. and triplicate to be retained as office copy.
11) Report of examination of a victim alleged to have been drugged - in a book form
with Original (perforated to make detachable) for issuing to the Police Officer and
 duplicate (perforated to make detachable) to be issued to the victim or the person
nominated by the victim and the triplicate to be retained as office copy.
12) Certificate of physical examination by a Medical Officer - in a book form with
Original (perforated to make detachable) for issuing to the Judicial / Police Officer
and duplicate (perforated to make detachable) to be issued to the person
examined or the person nominated by such person examined (when the
examination is undertaken as per the provisions of section 54 Cr.P.C.) and the
triplicate to be retained as office copy.
13) Certificate of Examination by a Specialist Medical Officer / Team of Specialist
Medical Officers - in a book form with Original (perforated to make detachable) for
issuing to the Judicial / Police Officer and duplicate (perforated to make
detachable) to be issued to the person examined or the person nominated by such
person examined (when the examination is undertaken as per provisions of section
54 Cr.P.C.) and the triplicate to be retained as office copy.
14) Certificate of collection of material objects from the body of a person for chemical
examination, DNA profiling, examination at FSL or any other such analysis, up on
written requisition from a Judicial / Police officer - in a book form with Original
(perforated to make detachable) for issuing to the Officer who accompany the
person from the body of whom the material objects are to be collected duplicate
(perforated to make detachable) to be issued to the person from the body of whom
the material objects were collected or the person nominated by such person (when
the collection of material objects is undertaken as per provisions of section 54
Cr.P.C.) and the triplicate to be retained as office copy on which the dated
signature of the police constable who receives the material objects is to be
obtained.
15) Label to be attached to the material objects preserved during a medico-legal
examination – in a book form with original perforated to make detachable and
further perforated to make each label detachable separately and duplicate
perforated to make detachable as a single sheet, for attaching to the report
forwarded with the material objects.
16) Report to be forwarded with material objects sent for chemical analysis – in a book
form with original perforated to make detachable for forwarding to the Chemical
 Examiner, and duplicate to be retained as office copy on which the dated signature
of the police constable who receives the material objects for forwarding to their
examination should be obtained.
17) Label to be affixed on the sealed packet containing different material objects
collected from one medico-legal case, for dispatching to the center of their analysis
– in a book form containing two labels on one page with each label perforated to
make detachable separately.
18) Intimation of preservation of material objects during medico-legal examinations - in
a book form with original perforated to make detachable for forwarding to the
officer who requested the medico-legal examination, and duplicate to be retained
as office copy on which the dated signature of the police constable who receives
the intimation should be obtained.
19) Report of examination of age - in a book form with Original (perforated to make
detachable) for issuing to the Police / Judicial Officer and duplicate (perforated to
make detachable) to be issued to the person examined or a person nominated by
him when the examination is conducted as per the provisions of Sec.54 of Cr.P.C.
and triplicate to be retained as office copy.
20) Requisition for X-ray examination of the subject brought for certification of age.
21) Mortuary Register – to serially record the details of every dead body kept in the
mortuary, in a calendar year-wise manner.
22) Register of Postmortem Examinations – to serially record the details of all
postmortem examinations, conducted in every institution, in a calendar year-wise
manner.
23) Receipt for dead body for postmortem examination.
24) Postmortem detailed notes – Each detailed note separately in a book form with at
least eight pages. One such book should be used for every postmortem
examination.
25) Postmortem certificate – To be typewritten in the prescribed format in
quadruplicate - Original for issuing to the concerned Court, duplicate for issuing to
Investigating police officer, triplicate to be retained as office copy and
quadruplicate to be issued to the legal heirs of the deceased on a No Objection
Certificate from the Investigating police officer.
26) Requisition for Histo-pathological examination of specimens preserved during
postmortem examination.
27) Label to be attached to material objects sent for chemical analysis (Preserved
during postmortem examination) - in a book form with original perforated to make
detachable and further perforated to make each label detachable separately and
duplicate perforated to make detachable as a single sheet, for attaching to the
report forwarded with the material objects..
28) Report to be forwarded with material objects sent for chemical analysis (Preserved
during postmortem examination).
29) Label to be affixed on the sealed packet for Chemical Analysis of Viscera and
other material objects, preserved from a case of postmortem examination, sent to
Chemical Examiner.
30) Final Postmortem Certificate (Final Opinion as to Cause of Death) – To be
typewritten in the prescribed format in quadruplicate with Original for issuing to the
concerned Court, duplicate for issuing to the Investigating police officer, triplicate to
be retained as office copy and quadruplicate to be issued to the legal heirs of the
deceased on a No Objection Certificate from the Investigating police officer.
31) Ambulance / Burial / Cremation / Embalming Certificate.
32) Format for referring a case for postmortem examination by a Police Surgeon
through the Executive Magistrate or Police Officer who held the inquest – To be
written in triplicate in a book form with Original (perforated to make detachable) for
issuing to the Magistrate or Investigating Police Officer, who held the inquest in the
case, duplicate (perforated to make detachable) for issuing to the Police Surgeon
to whom the case is referred, through the charge Head or Police constable and
triplicate to be retained as office copy.
33) Form of Application cum No Objection Certificate for issue of the quadruplicate
copy of the Postmortem Certificate.
34) Format for Application cum Certificate of authenticity of the copy of Postmortem
certificate, for the purpose of Insurance claim.
D. General Guidelines for examination and certification of medico-legal cases
1) Every medical officer undertaking medico-legal examination should make a complete
and thorough examination as is required in each type of such examination. He
 should record his findings elaborately. No column in the prescribed format should be
left blank. He should strike off whichever is not applicable, in the concerned
prescribed format.
2) He shall not use abbreviations (like Ab. for abrasion, LW for lacerated wound) while
writing the certificate. He shall not use symbols like # for fracture and should use
simple terms instead of complicated medical terms as far as possible. He shall do
the recording in a neat and legible manner and shall use capital letters when writing
the name, address etc.
3) Physical examination of a person without his consent is assault except in situations
specified by the Law. Hence consent should be obtained before conducting any
medico-legal examination on the body of the person except in situations where the
injured person directly comes to or is brought by anyone for treatment of injuries,
poisoning etc. Whenever a medico-legal examination is conducted on the body of a
person under arrest and up on a written requisition from a Judicial Officer or Police
officer not below the rank of a Sub Inspector of police, consent from the subject is
not necessary. When a request is made by a Police Officer of and above the rank of
a Sub Inspector for the examination of an arrested accused, it shall be lawful for the
doctor to use such force as is reasonably necessary for that purpose (This is in
conformity with amended Sec.53(1) Cr.P.C.). If the arrested accused is a female the
examination shall be made only by or under the supervision of a female doctor (This
is in conformity with the amended Sec52 (2) Cr.P.C.).
4) Consent should be written informed consent. The subject should write his name and
put his signature in continuation to consent written by him. When the subject is
illiterate, the doctor should write the sentence of informed consent and should read
over the same to the subject. Then the subject should sign or put his thumb
impression. Whenever a person not under arrest refuses consent, he should be
asked to write the informed refusal and sign the same.
5) Whenever an accused person under arrest is brought for the conduct of a medico-
legal examination with a requisition from a police officer not below the rank of a Sub
Inspector of police, and such person refuses consent for the said medico-legal
examination, the medical officer should examine the person even using reasonable
force, as per provisions of Sec.53 of Cr.P.C. Whenever a female accused is
 examined under this section, the examination shall be made only by, or under the
supervision of a female registered medical practitioner.
6) Whenever a person below the age of twelve years is to be examined up on the
written requisition of a Judicial / Police officer, consent should be obtained from the
parents of the subject or person who have the lawful guardianship of the subject at
the material time. Though a person above twelve years can give valid consent for a
physical examination, it is ideal to obtain the consent of the parent or guardian also
when the subject is below the age of eighteen years.
7) Whenever a medico-legal examination is conducted up on the written requisition
from a Judicial / Police officer, police intimation of such cases is not necessary.
8) Medico-legal examination and certification undertaken by Government institutions
shall only be conducted in institutions with prescribed facilities enlisted hereafter and
not in places like residential quarters of doctors or in places without the prescribed
facilities. All types of medico-legal examinations should be undertaken in all the
institutions authorized by this code, except in situations specified later.
9) All certificates should be printed in at least 30x21cm (A 4 Size) paper with good
quality. In the case of smaller formats like Police Intimation, Receipt for dead body
for Postmortem examination, Ambulance / Cremation / Burial certificate etc, two or
three formats may be printed in one page with original of each detachable
separately. Whenever certificates having duplicate and triplicate copies are printed in
book form, the paper of the original should be white in colour, duplicate light red and
triplicate light blue. While printing the registers, the heading need not be printed in
each page. It may be printed on the cover page of the register. (e.g., Medico-legal
Register for the year ………….., Mortuary Register for the year………………. etc.,)
10) The Head of Institutions should ensure the uninterrupted supply of all necessary
medico-legal formats to Medical Officers for use in the institutions under their control.
In Medical colleges and Institutions of Health Services Department, which are
directly under control of the Government, the cost of printing should be met from the
Hospital Development / Management Committee Funds on a top priority basis.
When such fund is deficient to meet the requirement for this purpose, the Head of
the institution should obtain the necessary funds for this from the concerned
department on an emergency basis. In institutions under the control of Local Bodies,
 the cost for printing the medico-legal formats should be met from the Hospital
Development / Management Committee funds. In institutions where such fund is
deficient or lacking, the Local Bodies in control of those institutions should provide
adequate funds to meet the printing cost, on a top priority basis. The Head of the
institution should take adequate steps for the printing the formats sufficiently early to
avoid exhaustion of the stock of formats in the institution.
11) The stock of formats for medico-legal certification should be under the custody of the
Head of the institution. He may depute an office staff working under him to handle
the issue of these formats to the various departments using such formats, on
sanction from the Head of the institution. The staff so deputed may be instructed to
intimate the need for printing any format, at least three months prior to the
anticipated exhaustion of stock of that format.
12) In all the institutions authorized to undertake medico-legal work, the head of the
institution (in case of Medical Colleges and Institutions directly under control of the
Government) or the Local Bodies having control of the institution, should ensure the
establishment of all necessary facilities to undertake such work. This should include
the formats for certification, space and equipments to undertake the various
examinations, adequate supporting staff, facilities and equipments for the collection
and preservation of material objects relevant in each type of cases, materials
necessary for the forwarding of such evidences etc. The controlling officer of the
institution/Department should ensure the service of the staff, including doctors, for
undertaking the medico-legal work in the institutions authorized to undertake it. In
institutions undertaking postmortem examination, the head of the institution should
ensure the establishment of facilities for the preservation of dead bodies, appropriate
protection devices for doctors and staff conducting autopsy in par with specifications
of Universal Precautions, adequate drainage and other waste management facilities,
facilities required for the storage, preservation and forwarding of the viscera and
other material objects and the facilities for the typewriting of the postmortem
certificate.
13) In Government sector, all Medical Colleges under the Medical Education Department
and all General Hospitals, District Hospitals, Taluk Head Quarters Hospitals and
Community Health Centers under the Health Services Department will be specified
 as authorized institutions under Government of Kerala, for undertaking medico-legal
work. All Government Hospitals and Health Centres where round the clock service is
provided are also authorized to undertake medico-legal work. All other Government
Hospitals, Primary Health Centres and other institutions under Health Services
department, where round the clock service is not provided and are functioning at
specified hours of the day, and which are currently undertaking medico-legal work
are authorized to undertake medico-legal work at all the time the institution is open
for work and a registered medical practitioner is on duty in such institution
14) All Primary Health Centers where round the clock services are not provided and
which are currently not undertaking medico-legal work are exempted from
undertaking medico-legal work provided there is an institution under Government of
Kerala which is authorized to undertake medico-legal work as detailed above, within
a radius of sixteen kilometers of the location of the Primary Health Center.
Registered Medical Practitioners working in such Primary Health Centers can refer
the request for all medico-legal examination from a Judicial / Police officer to the
nearest institution under Government of Kerala and authorized to undertake medico-
legal work as per this code, provided the institution to which the request is referred is
within sixteen kilometers of the Primary Health Center.
15) No doctor working in such institutions as specified to be undertaking medico-legal
work by this code and on duty in the particular institution shall refuse to undertake
medico-legal work. However, he can refer any medico-legal examination when
 The medico-legal certification requested is to be done by a specialist or medical
officer of one gender other than him and the particular specialist or medical officer
from that gender is not on duty at the particular time and he is reasonably sure that
the service of the particular specialist or medical officer from that gender cannot be
arranged within a reasonable time and also he is reasonably sure that such referral
will not cause loss of any evidence due to decomposition or other reasons.
 Upon doing or having completed the medico-legal work requested, he, on the basis
of available data, reasonably feel that there are findings of the nature demanding
the handling of the case by an expert in a specialty and such specialist is not on
duty in that institution at that particular time and he is reasonably sure that the
service of the particular specialist cannot be arranged within a reasonable time.
16) First aid to any injured person, with the objective of saving life is the primary
responsibility of any qualified medical practitioner. This should not be denied to any
person in any institution, whether Government or Private, opened on work at that
time with a registered medical practitioner on duty, for any reason. The doctor on
duty at that institution should provide adequate first aid fulfilling its objective and
without modifying the wounds, if the doctor cannot provide curative management to
the patient on justifiable grounds, such as lack of facility etc. The doctor should
record the wound certificate, in the manner prescribed hereafter and also should
intimate the police, regarding the arrival of such person with injury. Then he should
refer the injured person to the nearest institution with medico-legal certification
facility, mentioning the treatment given by him in the reference letter. If the doctor
feels that the injured person requires such expert treatment as available in tertiary
centers like Medical Colleges, he can directly refer the patient to such institution. He
should specifically write in the reference letter, the fact that wounds were not
described in detail, in the Wound Certificate. This will avoid further problems, if the
injured person directly goes to some other institutions with a tertiary status. This
approach should also be adopted in the case of victim of recent sexual assault, in an
injured or unconscious state, brought for treatment.
17) Also, every doctor practicing Modern Medicine is bound to examine, without any
delay, a female victim of sexual assault brought to or coming to the doctor and to
record the findings of such examination, in the manner required by the Law and
conforming to the Supreme Court Order in this regard, except in situations where the
victim refuses consent for such examination. The doctor is also bound to preserve all
the available material objects which may be of help in the further investigation of the
case (e.g. Clothes, Vaginal swab, etc), with a view to avoid loss of findings due to
delay in collection and preservation. The victim has the right to exercise the choice
of Examiner’s gender, and consent should be obtained before beginning the
examination proper. The doctor shall not, under any circumstances, disclose the
identity of the victim or the findings of his examination, to anyone other than the
Investigating Officer or the Hon’ble Court. As far as possible, the examination of a
victim of rape should be done by a lady medical officer. This principle regarding the
treatment and fulfillment of medico-legal responsibility to the injured and victim of
 sexual assault, is also applicable to all medical institutions in Co-operative and
Private sector, which is open for work and with a registered medical practitioner, on
duty at the particular time.
18) Whenever a person accused of rape is brought for examination to a registered
medical practitioner employed in a hospital run by Government or by a local body or
in the absence of such a practitioner within the radius of sixteen kilometers from the
place where the offence has been committed, to any other registered medical
practitioner, the registered medical practitioner should conduct the examination
without any delay and prepare a report immediately. The report should conform to
the conditions laid down as per the provisions of Sec. 53A of Cr.P.C. The report
should be immediately forwarded to the investigating officer.
19) Examination by a Specialist Medical Officer / Team of Specialists should be done in
the Government Medical Colleges of the state. However, this can be done in a
General or District Hospital, if the particular one or all specialist doctor(s) needed is
present and is on duty in the particular hospital / or can be arranged, at the time of
making such request for examination.
20) For examination and certification of age, the radiological examination should only be
done in the Radiology Department or X-ray unit of the institution to which the
doctor(s) conducting the age examination is attached.
21) Postmortem examinations shall be undertaken only in Institutions with a Mortuary
attached. In view of the comments made by various Courts and in the light of
concepts related to Human Rights, postmortem examination should only be
undertaken inside a mortuary, in all possible cases. No doctor shall open or
dismember a human dead body, for the purpose of a complete medico-legal
postmortem examination, in front of the relatives of the deceased, public or any such
person who is not authorized to be present during postmortem examination, as per
the specifications or authorizations of the Government of Kerala.
22) All medico-legal examinations should be serially numbered. Numbering is essential
for the purpose of future tracing of a particular certificate and also for identification of
the material objects, analyzed chemically or otherwise, at centers other than that of
their collection. The present method of serially numbering the wound certificates,
drunkenness certificates and postmortem examinations separately in each institution
 should be continued. For all other medico-legal examinations, identified so by this
code, the system of numbering ML / Serial Number / Abbreviation of Type of
Examination / Year, should be followed. For examination of a male accused in
sexual offence, including the examination of his potency examination, the
abbreviation should be MASO, for examination of a female victim of sexual assault
FVSA, for examination of a victim of unnatural sexual offence VUSO, for
examination of a female to look for signs of recent delivery it should be SRD, for
examination of a victim alleged to have drugged it should be VAD, for physical
examination of a person by a medical officer / specialist, it should be PES, for
collection of material objects from the body of a person up on the requisition from a
Judicial / Police officer, it should be CMO, for age determination AGE and for all
other examinations it should be abbreviation of Subject Examination SE. Whenever
these medico-legal examinations are undertaken, they should be entered in the
Medico-legal Register in the prescribed form. Police Surgeons should maintain a
separate Medico-legal Register in their office. In institutions where one type of
examination is exclusively undertaken in one department, like examination of female
victim of sexual assault in the Gynecology department of Medical Colleges or District
Hospitals, they can maintain a separate Medico-legal register in that department.
23) All medico-legal certificates should be duly signed by the medical officer who
conducts the examination and certification. The name of the medical officer should
be legibly recorded under the signature. Qualifications, registration number and
designation of the medical officer should also be recorded. In all medico-legal
certificates, office seal must be present.
24) Lack of space should not be the limiting factor in recording the findings in any
medico-legal certificate. The doctor should write the findings in the maximum
elaborate manner, using additional sheets as required. When additional sheets are
used, at the bottom end of the original format and all subsequent additional sheets
except the last one, it should be written that ‘continued in next page’. Each such
additional sheet should bear page number in a serial manner. Each additional sheet
should contain the serial number of the medico-legal examination, date, name, age
and address of the person examined at the top and should be signed at the bottom.
The name of doctor, name of institution and office seal should also be present at the
 bottom of each page. If no additional sheets are added, write nil in the column
provided in the wound certificate. As far as possible, no recording should be done on
the back page of the certificate.
25) Whenever any material object is collected from the body of a person as per the
request from a Judicial or Police Officer, who makes the request for collection of
material objects either as part of requisition for a medico-legal examination or solely
for the collection of such material objects, all such material objects collected should
be packed, labeled and sealed immediately and handed over to the officer
accompanying the person examined. When a medico-legal examination is
undertaken up on the written request from a Judicial or Police officer and if the
doctor think that examination chemically or otherwise by an agency authorized by
Government for that purpose, of any material object(s) collected from the body of the
person examined will have to be depended up on for arriving at a correct conclusion,
the doctor can collect such material object(s) even though the same is not requested
in the requisition for medico-legal examination. Such material objects are also to be
handed over immediately in the manner prescribed above. The officer, who bring or
accompany the person to be examined, shall not refuse to receive such material
objects and the requisition for their examination. Requisition for the concerned
examination should also be given with the sealed and labeled packet of material
objects when the material objects are sent to Chemical Examiner to Government.
For material objects sent to Forensic Science Laboratory, requisition need not be
given. The Investigating Officer should take over the material objects on a seizure
mahasser and shall forward it to FSL through the concerned Court.
26) When material objects are preserved during any medico-legal examination,
conducted without requisition from the Judicial or police officer (e.g., Stomach
aspirate from cases of poisoning brought for treatment), the doctor should record the
details of such material objects preserved in the certificate and also intimate the
same to concerned investigating police officer. The investigating officer, if he feels
that the examination of such material objects is necessary for the purpose of
investigation of the case, shall make arrangements for the transportation of such
material objects to the destination of their examination chemically or otherwise within
two weeks of the date of preservation. The doctor is not, in any case bound to
 preserve such material objects beyond a period of three months of their date of
preservation. In all cases, the label to be affixed on the individual bottles/packets of
material objects should be written in duplicate, using carbon paper. The carbon copy
should be attached to the requisition for chemical analysis sent to the Chemical
examiner to Government. Separate registers of the viscera and other material
objects dispatched and that of the reports of their analysis received should be
maintained in the office of the Police Surgeon / Institution, as the case may be.
27) In all instances where a patient with an injury is admitted to and treated to complete
recovery in the same hospital, the duplicate copy of the Wound Certificate entitled to
the injured, should be attached to the case sheet so that the treating doctor can
peruse the same during the course of treatment and also while recording the
discharge certificate. In such cases, the duplicate copy of the wound certificate and
discharge certificate may be issued together at the time of discharge. The injured,
except when examined as per provisions of sec.53 of Cr.P.C. has a right to get the
duplicate copy of the wound certificate and discharge certificate, within seven clear
working days of his discharge from the hospital. When an arrested accused person
is examined at his request and on the orders of a Magistrate, the doctor shall furnish
to him or his nominee a copy of the certificate and obtain his acknowledgement (This
is in conformity with amended Sec.54(2) Cr.P.C.). When an injured person is
referred to a higher center, the duplicate copy of the wound certificate should be
issued immediately along with the reference letter. The treating doctor at the higher
center has a right to get the duplicate copy of the wound certificate, for keeping
along with the case sheet. However, he is bound to return the same, with the
duplicate copy of the treatment / discharge certificate.
28) Wound Certificates (except in situations where the duplicate is issued to the injured
person when he is referred to another center and in cases where the injured was
brought with a requisition from the Police or Judicial Officer), Discharge Certificate in
continuation to Wound Certificate (except in cases where the injured was brought
with a requisition from the Police or Judicial Officer) fourth copy of the postmortem
certificate which is given to the legal heirs of the deceased (on a No Objection
Certificate from the Investigating Officer) should be issued through the office of the
institution, on a written requisition for the same. In institutions where there is a
 medical record library functioning, the issue of these certificates should be done by
the Officer in charge of it. In institutions without a medical record library, a clerk or
such officer may be put in charge of the issue of certificates. In institutions where
Police Surgeons are working, the issue of medico-legal certificates prepared by them
will be the responsibility of the Police Surgeon. Separate requisition for the issue of
any medico-legal certificate is not necessary when the medico-legal examination is
conducted on a written requisition from a Judicial or Police Officer since the
requisition for the medico-legal examination contains the request for certificate also.
29) However, on a written requisition for the immediate issue of any medico-legal
document, from a Police or Judicial Officer, the immediate issue of such medico-
legal document should be done by the Medical Officer on duty in that Institution and
in temporary custody of such documents at that particular time.
30) Certificate of drunkenness, Certificate of Potency, Certificate of examination of a
victim of Sexual Assault, Certificate of examination by a Medical Officer / Specialist /
Team of Specialists and any such medico-legal certificate with the exception of
postmortem certificate, prepared on a written requisition from a Police or Judicial
Officer, should be issued immediately. Acknowledgement of receipt should be
obtained on the back of office copy of the certificate. The Officer receiving the
medico-legal certificate should put his signature, write his name, designation,
address and date on the space provided at the bottom end of the office copy of the
certificate or on its back side.
31) Before the issue of the book containing the proforma of such medico-legal
certificates which are to be issued immediately up on completion of the examination,
official seal of the institution should be put at the space marked on every original and
duplicate of the certificate. This will ensure the immediate issue of the certificate
bearing office seal.
32) When any medico-legal examination including postmortem examination is conducted
on the written requisition from a Judicial or Police Officer, and when such
examination is not as per the provisions of Sec.54 Cr.P.C., the person examined or a
person authorized by such person examined or the legal heirs of the examined in the
event of the death of the person who was examined, are entitled to have a copy of
 the Certificate of examination only on a No Objection Certificate from the Judicial or
Police officer who has requested such examination.
33) An arrested person examined as per Sec.54 of Cr.P.C., is entitled to have a copy of
the certificate of examination of his body. However, he is not entitled to have the
copy of the certificate of examination of the victim in the criminal act in which the
person stands accused and was arrested. Only the victim is entitled to have a copy
of the certificate of examination of the victim.
34) All the written requests for examination and certificate should be kept safely, as a
separate file. On exhaustion of the pages in the book containing the relevant format,
the book with the office copies of the certificate and concerned requisitions should
be handed over to the Officer in charge of medical record library in institutions where
such a facility is present. In institutions without a medical record library attached to
them, all such documents should be handed over to the office of the institution and a
clerk or such other staff should be entrusted with the custodianship of these
documents on behalf of the Head of the institution. In institutions where Police
Surgeons are working, they will continue to be in charge of the custodianship of the
medico-legal documents handled by them as part of their duty.
35) In all institutions where postmortem examinations are undertaken, a Typist should be
deputed for typewriting the postmortem certificate. The Head of the institution should
provide the service of a Typist / Confidential Assistant to the Police Surgeon working
in that institution. The honorarium for typewriting the postmortem certificate shall
only be sanctioned to the Typist / Confidential Assistant, who had actually
typewritten the certificate.
36) Medico-legal certificates may contain highly personal and confidential data regarding
the physical findings on the body of a person, like description of private parts of a
female, condition of vagina and hymen, details of male genitalia etc. Revelation of
such findings to anyone other than the Investigating Police Officer in the particular
case, The Hon’ble Court considering the case the person examined or the person
authorized by the person examined, will be violation of right to privacy of the person.
If, during the course of investigation of the particular case, these documents reach
the hands of any person having some vested interest in helping a suspect or
accused, that can affect the process of investigation. The doctor who conducts the
 examination or the institution, in which the examination is undertaken, may not be
aware of the stage of investigation of the case in all instances. Also, certificates like
postmortem certificate can be misused by persons other than the legal heirs of the
deceased or injured, to falsely claim Insurance and the like. The doctor who
conducts the examination or the institution in which the examination is undertaken
does not have the facility for verification of the actual status of any applicant for a
copy of the certificate, regarding his legal heirship in relation to the deceased or
injured. That was why a No Objection Certificate from the Investigating Police Officer
was insisted for the issue of the fourth copy of postmortem certificate, to the legal
heirs of the deceased, as per G.O. No.18626/G2/69/Health dated 01-07-1969. In any
case, it can be seen that every medico-legal certificate or its copy will pass through
the hands of and will remain in the hands of an Investigating Police Officer or
Magistrate. When requests are made for the copy of any medico-legal certificate, by
persons other than the injured or persons other than those who are lawfully entitled
to receive it on behalf of the injured or persons other than those who bear the legal
heirship of the deceased, and when those requests are as per the Right To
Information Act, such requests should be made to the Investigating Police Officer or
Magistrate, who are having such certificate under their custody. In the event of
tracing of such certificates becoming impossible from their office, due to any reason,
the Police Officer or Magistrate can direct the doctor or head of the institution having
the office copy of the certificate under their custody, to issue an attested copy/copies
of the certificate to the Police Officer or Magistrate, which can be issued to the
claimant by the Police Officer or Magistrate. Information regarding the medico-legal
examination and certification by a doctor or institution, other than the copy of the
medico-legal certificates and their contents, like the number of postmortem
examinations, types of cases attended to, numbers of persons attended to with
history of assault or accident etc, should be furnished by the head of the institution,
as per the provisions of the Right to Information Act.
37) Office copy of the medico-legal certificates and all documents related to it should be
kept in the office of the institution or police surgeons / medical record library for
unlimited time. Destruction of these documents should not be made by any person
for any reason.
38) Fee any, if fixed by the Government for the issue of these certificates, such fee
should be collected only through the office of the institution. Issue of the certificates
may be done by officers specified above after verifying the receipts for the payment
of such fee.
39) Police Surgeons should be provided with a separate office in the Institution to which
they are attached. The Head of the institution should provide adequate facilities like
the service of assisting staff including a Confidential Assistant / Typist / Clerk,
furniture, a computer, facilities for keeping the medico-legal records under safe
custody etc and the materials necessary for the smooth maintenance of medico-
legal work. Office of the Police Surgeon should have an Office Seal and a metallic
seal for making the immediate handing over of the Medico-legal Certificates in
necessary cases, for the immediate forwarding of the viscera and other material
objects and for making the immediate handing over on seizure mahessar, of material
objects for examination at FSL, material objects for DNA fingerprinting etc, so that
the chain of custody of such material objects will not be disputed in the Court of Law.
40) Police surgeons will be exempted from all routine hospital work including ward work,
work in casualty, out-patient department etc. However, they will continue to provide
advice on medico-legal matters to all other doctors in the institution and also doctors
working in areas specified as under the jurisdiction of police surgeons. All routine
medico-legal work except postmortem examination will be undertaken by routine
duty/casualty Medical Officers or specialists to be specified hereafter. Routine
medico-legal work like collection of blood or other material objects for the purpose of
DNA profiling or chemical analysis etc at the request of Judicial or Police officers will
be done by routine duty/casualty Medical Officers. Only such medico-legal work
which requires the examination and interpretation of findings by a qualified medico-
legal expert should be sent to Police Surgeons.
41) Access to the medico-legal data in the computer in the office of the Police Surgeons
should be limited to Police Surgeons and the Clerk / Typist allotted to Police
Surgeons. Access to such data should be protected by password.
42) The honorarium for conducting postmortem examination should be disbursed on a
monthly basis. The clerk / typist who typewrite the postmortem certificate should
prepare the monthly statement of this honorarium, to be disbursed to the eligible
 doctors / staff, indicating the number of cases attended to by each category of
doctors / staff and the amount to be disbursed to each of them. The head of the
institution, after proper verification, should sanction the same without any delay.
43) Medico-legal examinations including postmortem examination, which are undertaken
on any person or on the dead body of any person, on the written requisition from a
Police or Judicial Officer who is lawfully authorized to issue such requisition, is a
strictly legal affair and the medical officer who has conducted such medico-legal
examination shall not communicate with anyone other than the Investigating Officer
and the Executive or judicial Magistrate, regarding the findings of such examination
or the interpretation their of, without permission from the Investigating Officer or the
Magistrate. Such communications should be according to any of the provisions of
the I.P.C., Cr.P.C. or Indian Evidence Act. However, the Medical Officer who has
undertaken the medico-legal examination can certify the authenticity of the certificate
of such examination, its contents and opinion furnished thereon, issued by them, on
production of the copy of such certificate only if such copy was issued by the police
Officer or Magistrate and also if issued by the Medical Officer himself or by the
institution to which he is attached where such issue is in accordance to the norms
prescribed earlier.
44) For the continued maintenance of quality of medico-legal work, a committee
consisting of representatives of Government from the Health, Law and Home
Departments, Director of Health Services, Director of Medical Education and senior
most Medico-legal experts from Health Services and Medical Education
Departments should be formed. Periodic revision of the code should be undertaken
by the committee, at least on a yearly basis.
45) Departmental training in medico-legal matters should be arranged regularly to
medical officers and all staff of Health Services and Medical Education Departments
and also to Officers of the Police Department. A copy of this code should be
published in arogyakeralam.com, the official website of Health Department.
E. Additional guidelines : The following additional guidelines are also prescribed for
the requirements, examination, documentation and maintenance and issue of
certificates, in various types of Medico-Legal certifications.
I. WOUND CERTIFICATION
The code prescribes adequate stock, in the institution, of the following medico-legal
and allied formats, appended in Annexure – I to this code, as the essential pre-
requisites for the fulfillment of duties in relation to wound certification.
a) Accident Register cum Wound Certificate
b) Police intimation
c) Proforma for recording Dying Declaration by a Registered Medical Practitioner.
d) Treatment/Discharge Certificate in continuation to Wound Certificate.
The code identify, apart from the mechanical, thermal, chemical, firearm and such
other injuries, cases of Poisoning also as injury and wound certificate should be written
in all cases of alleged poisoning. The code identifies the poison as the injurious agent or
weapon in such cases. Medical Officers should be aware of the importance of
preserving the material objects like stomach aspirate, vomitus particles, blood, urine etc,
the examination of which may help to identify such weapon or injurious agent, in cases
where such facts may have to be established in a Court of Law at a later stage. In a
case of alleged homicidal poisoning, if the victim survives for weeks in the hospital and
dies due to delayed effects or complications of poisoning, the particular poison may not
be detected by the chemical analysis of the viscera collected during postmortem
examination. If the stomach aspirate or blood of the victim is subjected to chemical
analysis, at the time of admission, the chance of detection of the poison will be definitely
more. Hence, it is also prescribed that in institutions which undertake treatment of such
cases of poisoning, adequate facilities for the collection, preservation and forwarding for
chemical analysis of such material objects, described in the following parts of this code,
should be available.
a) Accident Register cum Wound Certificate
1. The doctor working in any institution and who attends the injured person first,
should write the wound certificate, at the time he examines the person. Even in
situations where the patient is immediately referred to a higher center, the doctor
 should write the certificate, briefly mentioning the critical condition in the space for
recording the injuries. In continuation to that, he should add that detailed
description of injuries was not made in the wound certificate.
2. History and alleged cause of injury in column No.8, should be written in the injured
person’s own words, in all possible cases. Instead of just writing RTA, assault etc,
a brief history of what has happened should be recorded, at least with reference to
the manner of infliction and time of occurrence. When the injured person is
unconscious or otherwise unable to give exact details of what has happened, the
version of the person accompanying the injured person should be recorded,
specifying the name of person giving the history.
3. While recording the injuries, the prescribed method is in the order of type of injury,
size of injury, placement, site and distance from anatomical landmarks.
4. The duplicate copy should be issued to the injured person or to those authorized
by him or to those who are lawfully entitled to receive it on his behalf up on a
written requisition for the same. When the patient is referred to a higher center for
further or expert management, the duplicate copy may be issued immediately
along with the referral letter. In situations where the patient is severely injured or
unconscious and is unable to receive the wound certificate copy himself or to
authorize someone to receive it and when there are no persons lawfully entitled to
receive the copy on the injured person’s behalf, the doctor need not issue the
same to the available bystanders. In such situations the doctor should incorporate
the relevant points in the wound certificate in the referral letter.
b) Police Intimation
1. The Doctor is legally bound to intimate the Police, any unlawful act which comes to
his notice during consultation, examination, investigations, treatment or during any
such phase of interaction within the context of a doctor-patient relationship, when
such unlawful act comes under the purview of any of the sections of I.P.C. which
are applicable to offences concerning human body and also when such unlawful
act has actually caused or contributed in the causation of or if the victim of the
unlawful act or any person who is interested in the welfare of the victim has
reasons to think that the unlawful act has actually caused or contributed in the
causation of any of the factors that made the victim of such unlawful act to either
 directly approach the doctor or made someone else to take the victim of such
unlawful act to the doctor. The doctor need not take the consent of the injured or
the victim of unlawful act or of those who brought the injured or victim of unlawful
act to the doctor or that of his or her parents or legal guardians when the injured or
victim of unlawful act is a minor.
2. Police intimation should be given immediately after recording the wound certificate,
in all possible instances.
3. This should be specifically followed in cases of death intimations and in situations
where the patient is referred to another hospital or treated as outpatient only. In all
other instances, the doctor/institution has a responsibility to transmit the intimation
within 24hours of recording the wound certificate.
4. When immediate transmission of the written intimation is not practical in any
situation, over phone intimation should be made and the same should be recorded
in the written intimation.
5. Intimation should be written in duplicate. The original should be issued to the police
and the receipt of the same may be acknowledged on the office copy by the Officer
receiving the same.
6. All cases of natural deaths should be intimated to the Local Body, which is
maintaining the Register of births and deaths. All cases of unnatural deaths should
be intimated to Police. In all cases where the doctor is not able to decide between
death due to natural causes and unnatural deaths, e.g., person brought dead to
hospital, intimation should be given to Police and the dead body should be kept in
the mortuary. In any such cases, if the concerned Police Officer, after making
necessary enquiries, gives a written requisition for the release of a body, that
should be complied with, immediately.
7. In cases where the doctor has given death intimation to the Police, he need not
give further intimation to the Local Body/Authority, which is maintaining the
Register of births and deaths. Since the inquest is enquiry into cause of death and
the objective of postmortem examination is to find out the cause of death, the
doctor cannot certify a cause of death as required in the prescribed form of
intimation to Local Body/Authority, which is maintaining the Register of births, and
 deaths. In all such cases, the Police Officer shall give the intimation to Local
Body/Authority, which is maintaining the Register of births and deaths.
c) Proforma for recording Dying Declaration
by a Medical Practitioner
Dying declaration should be recorded by the treating or attending doctor when he
has reasons to believe that the condition of the patient is critical, death may occur at
any time thereafter and there is not enough time to inform the Magistrate through Police
and arrange the recording of the dying declaration by the Magistrate. All columns should
be carefully filled in. Original of the dying declaration should be forwarded to the
Magistrate in a sealed cover and duplicate should be retained as office copy, as a highly
confidential report. The doctor shall not disclose anything recorded in the dying
declaration, to anyone other than the Investigating Officer or any Officer legally
authorized by the Investigating Officer.
Whenever a Judicial Magistrate is recording the dying declaration, the
Investigating Officer who has requested the recording of the same has a duty to be
physically present throughout the period of recording the dying declaration. It shall be
the duty of a Medical Officer to comply with the direction of the Magistrate to examine to
examine a person brought or admitted in the hospital and to issue a certificate as to the
fitness of his condition to make a dying declaration (This is a legal responsibility of a
Medical Officer).
d) Treatment / Discharge Certificate in continuation to
Wound Certificate
1. Treatment / Discharge certificate in continuation to Wound Certificate should be
written only after perusing the relevant points in the wound certificate.
2. The doctor who actually treated the injured person or the doctor under the charge
of whom the injured person was being treated as inpatient should write the
treatment / discharge certificate in continuation to Wound Certificate, in spite of
other specialists being consulted during the treatment. When an injured person is
transferred from one department to another during the course of treatment of
injuries, the doctor who discharges the person on completion of treatment should
write the treatment / discharge certificate in continuation to Wound Certificate.
When such transfer of the injured person to another department is for the
 treatment of illness other than the injuries or any of the complication of such
injuries, the doctor who treated the injury should write the treatment / discharge
certificate in continuation to Wound Certificate.
3. The treatment / discharge certificate in continuation to Wound Certificate should be
written on the day of discharge of the injured person from the hospital. In any case
the doctor who has treated the person has a responsibility to write the treatment /
discharge certificate in continuation to Wound Certificate within seven clear
working days of discharging the injured person.
II. DRUNKENNESS CERTIFICATION
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
drunkenness certification.
1) Format for certification of drunkenness and the formats of labels and forwarding
note for dispatching the material objects collected during examination.
2) Facilities and equipments for a proper physical examination, including recording
of blood pressure.
3) Facilities and equipments for collection of blood and urine.
4) An adequate stock of Sodium Fluoride.
5) Facilities and equipments for the packing and sealing of blood and urine
samples, including a metallic seal for affixing on melted wax, on the bottles and
packet forwarded for chemical analysis.
Certificate of Drunkenness
1) Smell of alcohol, which percolates through atmosphere, from the breath of the
subject and identifiable by the examiner at a distance of 30cm from the nose of the
subject may be taken as positive. Ceiling or table fans should be switched off while
looking for the smell of alcohol. The examiner should not smell the nose or mouth
of the subject and the subject should not be asked to blow his breath forcefully, for
the purpose of this examination. This smell should be persistent and should be
present at the beginning and at the end of examination.
2) Persistent smell of alcohol in breath, if present, opinion should be given that the
person has consumed alcohol. When higher functions or muscular co-ordination is
 impaired and there is persistent smell of alcohol in breath, opinion that the person
has consumed alcohol and is under the influence of alcohol should be furnished.
3) When blood is being preserved for chemical analysis, spirit should not be used as
the disinfectant to clean the skin before vene-puncture.
4) Whenever blood is preserved for chemical examination, it is ideal that urine is also
preserved. The subject should be asked to void urine before the onset of
examination and the sample for analysis should be collected from urine voided
after the examination. 5ml each of blood and urine should be preserved and
Sodium Fluoride should be added as preservative. (50mg of Sodium Fluoride for
10ml of blood).
5) In all cases of alleged drunken driving, preservation of blood is mandatory.
III. EXAMINATION & CERTIFICATION OF A MALE ACCUSED IN SEXUAL
OFFENCE INCLUDING THE EXAMINATION OF POTENCY
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
examination of male accused in sexual offence, including the examination of potency
1) Format for report of examination of a male accused in sexual offence, including
the examination of his potency and the formats of labels and forwarding note for
dispatching the material objects collected during examination.
2) Facilities and equipments for a proper physical examination in adequate privacy.
3) Equipments for measuring height, weight and for recording blood pressure.
4) Facilities and equipments for collection, packing and sealing of penile swabs and
washings, including cotton, normal saline and a metallic seal for affixing on
melted wax, on the bottles and packet forwarded for chemical analysis.
Examination and Certification of a male accused in sexual offence, including the
examination of potency
1) The examination of a male accused in rape should be done conforming the
conditions stipulated as per Section 53A of cr.P.C.
2) Examination of a male accused in sexual offence, including the examination of
potency should be attended to, by all Medical Officers, irrespective of the gender of
 the doctor, who are on duty in the particular institution authorized to undertake
medico-legal certification, on that day.
3) When there is a request to look for recent sexual act, the examination should be
done without any delay. Preservation of penile swabs and penile washings is
mandatory in such cases.
4) Preservation of the relevant material objects is mandatory in all cases when the
accused person is brought for examination within 72hours of the alleged incident.
When the accused person is brought after a period of seven days of the alleged
incident, the doctor need not preserve the material objects. However, he should
preserve material objects like blood for DNA profiling, hairs etc, if the same is
requested for.
IV. EXAMINATION AND CERTIFICATION OF A FEMALE VICTIM OF SEXUAL ASSAULT
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
examination and certification of a female victim of sexual assault.
1) Format for report of examination of a female victim of Sexual Assault and the
formats of labels and forwarding note for dispatching the material objects collected
during examination
2) An examination table, preferably the one on which the victim can be examined in
the lithotomy position.
3) Facilities and equipments for a proper physical examination in adequate privacy
and under proper conditions of light.
4) Equipments for measuring height, weight and for recording blood pressure and a
systematic medical examination.
5) Facilities and equipments for collection, packing and sealing of vaginal swabs,
smears, pubic hair combings, clothes and any such material object, the
examination of which may have a bearing on the case, including cotton, glass
slides etc and a metallic seal for affixing on melted wax, on the bottles and packet
forwarded for chemical analysis.
6) There should also be facilities for collection and preservation of blood and urine
samples, as may be necessary in cases of sexual assault on the female victim
intoxicated with drugs, alcohol etc.
Examination and Certification of a female victim of Sexual Assault
1) Whenever a female victim of alleged Sexual Assault directly come to or is brought
to a doctor, the doctor should, after obtaining her consent, immediately examine
the victim, intimate police and preserve all possible evidence for examination. In
institutions where at least two Gynecologists are working on call duty basis, the
examination of a victim of sexual assault should be undertaken by the
Gynecologist on call duty on that day. As far as possible, the examination should
be done by a female medical officer.
2) A proper history should be obtained in the victim’s own words and should be
recorded as such. All columns should be carefully filled in. Care should be taken to
strike off whichever is not applicable in the findings and opinion parts. When there
are injuries to the genitalia and/or on the body, they should be described in detail
and the age of the injuries (whether fresh or of age assessed by appearance)
should be noted.
3) When vaginal swab is preserved in cases of Sexual Assault in recent past, at least
two swabs should be properly preserved, so that DNA profiling can be done in the
second swab, on detection of spermatozoa in the first swab.
4) The doctor shall not order tests like that for HIV testing on his own and which has
no relevance as far as the recording of injuries or their treatment is concerned.
However, the doctor shall convince the victim, of the importance of these tests and
with informed written consent from the victim, shall send her to the nearest I.C.T.C.
or such other centers.
5) The original of the certificate should be issued to the Investigating officer and the
triplicate should be retained as the office copy. When the victim directly comes to
the doctor, she has a right to get the duplicate copy of the certificate. Care should
be taken to maintain secrecy of the details regarding the identity of the victim of
sexual assault and the examination findings.
6) The following material objects may be preserved for examination from a female
victim of sexual assault –
  Vaginal swabs – at least two swabs for examination to look for semen and
one for DNA profiling
 Vaginal smear to look for spermatozoa
 Nail clippings to look for foreign fibers, particles, hairs, epithelial cells etc.
 Loose hair combings from pubic region to look for foreign hairs.
 Pubic hair (cut) samples for comparison.
 Clothes
 Urine for pregnancy test.
 Blood for chemical analysis
 Urine for chemical analysis
 Any other, as the nature of the case demands.
7) Preservation of all the material objects is mandatory in all cases when the female
victim of sexual assault is brought for examination within 72hours of the alleged
incident. When the victim is brought after a period of seven days of the alleged
incident, the doctor need not preserve the material objects. However, he should
preserve material objects like blood for DNA profiling, hairs etc, if the same is
requested by the investigating officer. He should send the urine for pregnancy
test if pregnancy is suspected..
V. EXAMINATION AND CERTIFICATION OF A VICTIM OF UNNATURAL
SEXUAL OFFENCE
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
examination and certification of a victim of unnatural sexual offence.
1) Format for report of examination of a victim of Unnatural Sexual Offence and the
formats of labels and forwarding note for dispatching the material objects collected
during examination.
2) Facilities and equipments for a proper physical examination in adequate privacy
and under proper conditions of light.
3) Equipments for measuring height, weight and for recording blood pressure.
4) Facilities and equipments for collection, packing and sealing of buccal swabs, anal
swabs, clothes and any such material object, the examination of which may have a
 bearing on the case, including cotton, glass slides etc and a metallic seal for
affixing on melted wax, on the bottles and packet forwarded for chemical analysis.
5) There should also be facilities for collection and preservation of blood and urine
samples, as may be necessary in cases of victim of unnatural sexual offences
intoxicated with drugs, alcohol etc.
Examination and Certification of a victim of Unnatural Sexual Offences
1) Whenever a victim of Unnatural Sexual Offences directly come to or is brought by
anyone other than a Police Officer, to a doctor working in an institution and on
duty, the doctor should, after obtaining his consent, immediately examine the
victim, intimate the police and preserve all possible evidence for examination.
2) When a victim of unnatural sexual offence is brought with a requisition from a
Police or a Judicial Officer, intimation is not necessary.
3) A proper history should be obtained in the victim’s own words and should be
recorded as such. All columns should be carefully filled in. Care should be taken to
strike off whichever is not applicable in the findings and opinion parts. When there
are injuries to the oral cavity, anus, genitalia and/or on other parts of the body, they
should be described in detail and the age of the injuries (whether fresh or of age
assessed by appearance) should be noted.
4) The doctor shall not order tests like that for HIV testing on his own and which has
no relevance as far as the recording of injuries or their treatment is concerned.
However, the doctor shall convince the victim, of the importance of these tests and
with informed written consent from the victim, shall send him to the nearest
V.C.T.C. or such other centers.
5) Care should be taken to maintain secrecy of the details regarding the identity of the
victim and the examination findings.
6) The following material objects may be preserved for examination from a victim of
unnatural sexual assault –
a. Buccal swabs – at least two swabs for examination to look for semen and
one for DNA profiling.
b. Anal swabs
c. Swab from skin of thighs, with cotton soaked in normal saline.
d. Nail clippings to look for foreign fibers, particles, hairs, epithelial cells etc.
 e. Loose hairs from anal region and buttocks.
f. Pubic hair (cut) samples for comparison.
g. Clothes
h. Blood for chemical analysis
i. Urine for chemical analysis
j. Any other, as the nature of the case demands.
7) Preservation of all the material objects is mandatory in all cases when the victim of
unnatural sexual assault is brought for examination within 72hours of the alleged
incident. When the victim is brought after a period of seven days of the alleged
incident, the doctor need not preserve the material objects. However, he should
preserve material objects like blood for DNA profiling, hairs etc, if the same is
requested by the investigating officer.
VI. EXAMINATION OF A FEMALE TO LOOK FOR SIGNS OF RECENT DELIVERY
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
examination of a female to look for signs of recent delivery
1 Format for report of examination for signs of recent delivery and the formats of labels
and forwarding note for dispatching the material objects collected during
examination.
2 An examination table, preferably the one on which the victim can be examined in the
lithotomy position.
3 Facilities and equipments for a proper physical examination in adequate privacy and
under proper conditions of light.
4 Equipments for measuring height, weight and for recording blood pressure and a
systematic medical examination.
5 Facilities and equipments for collection, packing and sealing of material objects
Examination and Certification of a female to look for signs of recent delivery
1 Whenever a female with history of recent delivery or complaints suggestive of recent
delivery where the death of the newborn baby is reported in a suspicious manner or
those who bring the female gives such a suspicious history or no history regarding
the newborn baby is known or available and when such a female directly come to or
 is brought by anyone other than a Police Officer, to a doctor working in an institution,
the doctor should, after obtaining her consent, immediately examine the female to
look for signs of recent delivery, intimate the police and preserve all possible
evidence for examination.
2 When a female is brought for examination to look for signs of recent delivery, with a
requisition from a Police or a Judicial Officer, intimation is not necessary and
consent is mandatory.
3 In institutions where at least two Gynecologists are working on call duty basis, the
examination to look for signs of recent delivery should be undertaken by the
Gynecologist on call duty on that day. When a Gynecologist is not there in the
institution, the examination should be undertaken preferably by or under the
supervision of a lady medical officer.
4 The female has a right to exercise choice regarding the gender of the examining
doctor. When there is only a male medical officer on duty, he should arrange for the
examination of the female by a lady medical officer, at the earliest. When the life of
the female is in danger, e.g., profuse bleeding, the first priority will be to save the
patient and the doctor attending the patient is bound to examine and institute
appropriate treatment.
5 A proper history should be obtained in the subject’s own words and should be
recorded as such. Specific history in relation to gestational period, attempted
criminal abortion etc should be taken. All columns should be carefully filled in. Care
should be taken to strike off whichever is not applicable in the findings and opinion
parts. When there are injuries to the genitalia and/or on the body, they should be
described in detail.
VII. EXAMINATION & CERTIFICATION OF VICTIM ALLEGED TO HAVE BEEN DRUGGED
The code prescribes adequate stock, in the institution, of the following formats,
appended in Annexure – I to this code and also the materials and facilities enlisted
hereafter, as the essential pre-requisites for the fulfillment of duties in relation to
examination and certification of a victim alleged to have been drugged.
1) Format for report of examination of a victim alleged to have been drugged and the
formats of labels and forwarding note for dispatching the material objects collected
during examination.
2) Facilities and equipments for a proper physical examination in adequate privacy
and under proper conditions of light.
3) Equipments for measuring height, weight and for recording blood pressure and a
systematic medical examination.
4) Facilities and equipments for collection, packing and sealing of material objects,
the examination of which may have a bearing on the case, including cotton, glass
bottles etc and a metallic seal for affixing on melted wax, on the bottles and packet
forwarded for chemical analysis.
Examination and Certification of a victim alleged to have been drugged.
1) Whenever a victim alleged to have been drugged directly come to or is brought by
anyone other than a Police Officer, to a doctor working in an institution and on
duty, the doctor should, after obtaining his consent, immediately examine the
victim, intimate the police and preserve all possible evidence for examination.
2) A proper history with specific attention to the mode of administration, loss of
consciousness etc., should be obtained in the victim’s own words and should be
recorded as such, in all possible cases. When there are injuries to the oral cavity,
circum oral regions, injection marks, and/or injuries on other parts of the body, they
should be described in detail and the age of the injuries (whether fresh or of age
assessed by appearance) should also be noted.
3) The following material objects may be preserved for examination from a victim
alleged to have been drugged –
a. Nasal swabs – to look for narcotic, sedative, anesthetic or other such drugs
b. Vomit particles
c. Blood.
d. Urine.
e. Any other, as the nature of the case demands.
4) Preservation of the relevant material objects is mandatory in all cases when the
victim alleged to have been drugged is brought for examination within 72hours of
the alleged incident. Preservation is not necessary when the victim is brought for
examination after seven days of the alleged incident.

VIII. CERTIFICATE OF PHYSICAL EXAMINATION BY A MEDICAL OFFICER

1) This examination should be done on the written requisition from a Police or Judicial
Officer. It is ideal to obtain consent before begining the examination.
2) Whenever a female accused under arrest is examined, the examination shall only
be conducted by or under the supervision of a Lady Medical Officer.
3) When done on persons before their admission to jail, history of any torture should
be specifically asked for.
4) The medical officer shall not, except in life saving situation for the person brought
for examination, admit the person, without the written permission from the officer
who issued the request for such examination.
5) Suggestions or comments regarding the condition of the person or treatment
should be written in the column provided.
6) In emergency situations where the medical officer has reasons to believe that the
person brought for examination, requires immediate in-patient treatment, under
direct supervision of a doctor, to save the life of the person, he should immediately
issue the certificate of physical examination to the officer who requested such
examination, recording his suggestions regarding the necessity of urgent
treatment. He can retain the patient under his care, till he gets a written permission
or refusal for his suggestion, from the officer who issued the request for
examination.
XI. POSTMORTEM EXAMINATION
The code prescribes adequate stock, in the institution, of the following medico-
legal and allied formats, appended in Annexure – I to this code and also the facilities
and materials enlisted hereafter, as the essential pre-requisites for the fulfillment of
duties in relation to Postmortem examination.
1) Mortuary Register.
2) Register of Postmortem Examinations.
3) Receipt for dead body for postmortem examination.
4) Postmortem detailed notes.
5) Postmortem certificate (To be typewritten in the prescribed format).
6) Requisition for Histo-pathological examination of specimens preserved during
postmortem examination
7) Intimation of preservation of viscera and other material objects.
 8) Label to be attached to material objects sent for chemical analysis (Preserved
during postmortem examination).
9) Report to be forwarded with material objects sent for chemical analysis
(Preserved during postmortem examination).
10) Label to be affixed on the sealed packet for Chemical Analysis of Viscera and
other material objects sent to Chemical Examiner
11) Final Postmortem Certificate (Final Opinion as to Cause of Death – To be
typewritten in the prescribed format).
12) Ambulance / Burial / Cremation / Embalming Certificate.
13) Format for referring a postmortem examination to a Police Surgeon through the
Executive Magistrate or Police Officer who held the inquest.
14) Form of Application cum No Objection Certificate for issue of the quadruplicate
copy of the Postmortem Certificate.
15) Format for Application cum Certificate of authenticity of the copy of Postmortem
certificate, for the purpose of Insurance claim.
There should be the following facilities and adequate stock of materials,
necessary for the proper undertaking of medico-legal postmortem examination and its
allied works.
1) A fully equipped mortuary.
2) Continuous water supply and Electricity to the mortuary.
3) A Generator for use in case of failure of power supply.
4) Adequate stock of all materials necessary for use of personnel taking part in the
postmortem examination, in par with the specifications prescribed as part of
Universal Precautions, including -
a) Latex Gloves, Facemasks and Surgeon’s caps.
b) Cotton gowns / disposable surgeon’s gowns and plastic aprons.
c) Gumboots, goggles and such other materials as may be necessary for
conducting postmortem examination on HIV Positive or decomposed dead
bodies.
5) Adequate stock of all materials necessary for the proper conduct of medico-legal
postmortem examination, including -
a) Surgical blades, Suturing needles, Nylon threads for suturing etc
 b) Cotton, bandage cloth, adhesive plaster etc
c) Postmortem kits containing all prescribed instruments.
6) Adequate stock of all materials necessary for cleaning and disinfection of the
mortuary and equipments - Bleaching powder, Phenol, Savlon, Soap etc.
7) Adequate stock of all materials necessary for preservation, packing and forwarding
the viscera and other material objects, as may be necessary in different types of
cases, including -
a) Glass / plastic containers for collection of viscera and other material objects.
b) Preservatives like common salt, sodium fluoride, formaldehyde etc.
c) Cotton and jute threads, metal seal for affixing on the bottles and packets etc.
Postmortem Examination
1) All Police Surgeons and Medical Officers in Health Services and Medical
Education Departments, appointed by Government of Kerala and Post Graduate
Students in the Department of Forensic Medicine of Government Medical Colleges,
are authorized to undertake Medico-legal Postmortem examinations, in addition to
those authorized by the Government of Kerala, vide Government Orders, issued till
date, in this regard.
2) Postmortem examinations shall only be conducted in institutions authorized to
undertake medico-legal work and with a Mortuary facility.
3) From now on, while selecting the location of mortuary, it should be with a view to
avoid the difficulties to patients and the Public, caused by the smell of decomposed
dead bodies kept and examined in the mortuary.
4) Every mortuary and its associated buildings should have a compound wall to
restrict the entry of unwanted persons and also to control the accompanying
persons, in situations where they turn out in large numbers.
5) The mortuary should have at least four rooms, one at least 20x20feet size where
postmortem examinations can be done, another room for storing the dead bodies,
third one for storing the viscera and material objects and one room to be used as
office. There should be a verandah of minimum 6 feet width and an open space of
at least 40x30 feet size in front of the mortuary building.
6) The blood and other waste products of postmortem examination, under any
circumstances, should not be allowed to flow in to the common drainage. The
 postmortem table should have a drainage line directly from it and leading to a tank
constructed in the similar manner as that of septic tank. A soak pit may be
constructed to drain the effluent fluid from the tank. The size of the tank may be in
accordance to the number of postmortem examinations conducted in the particular
mortuary, in every year. The site of the tank should be behind the mortuary
building. Only water used to clean the floor of the mortuary and its premises should
be allowed to drain to the common drainage.
7) The mortuary should have adequate facilities for lighting and ventilation. Exhaust
fans should be installed, in such a way that the patients and public are not in direct
exposure to the air from inside the mortuary.
8) There should be an inquest room of at least 20x20feet size, just outside the
compound wall of the mortuary, preferably near the main gate of the mortuary
compound. It should have electricity and water supply and minimum one table like
raised platform, for placing the body for inquest. The same platform can be used
by the relatives for packing the body, after postmortem examination.
9) Head of the institution / Local body in control of the institution has the responsibility
for the construction and maintenance of such buildings meeting the requirements.
Wherever possible, freezer facility (Cold Room type) should be provided to the
mortuary. In institutions where medico-legal postmortem examination is currently
undertaken, lack of any one or most of the facilities mentioned above should not be
taken as a reason to stop undertaking medico-legal postmortem examination. The
Head of such institutions and Local Bodies in control of such institutions should
make all possible efforts to see that all such facilities are established in the
institution within a reasonable time frame.
10) The custodianship of dead body, of which the inquest is over and is kept for
postmortem examination, will be the responsibility of the Resident Medical Officer
of the institution. The custodianship of dead bodies kept for postmortem
examination on which inquest is not over, unclaimed dead bodies and those kept in
mortuary awaiting the arrival of relatives, will continue to be vested on the Resident
Medical Officer.
11) The security of the dead body, of which the inquest is over and kept in a mortuary
will be the responsibility of the charge police constable deputed for the purpose.
 The security of the dead body kept in a mortuary for which inquest in not over or
not needed, should be ensured by the Head of the Institution and Local body in
control of the institution by making appropriate arrangements for the same.
12) The mortuary building should be constructed with a view to prevent animal or other
such type of action on the dead body kept there. The R.M.O. should inform the
possibility of such mishaps if any, to the head of the institution. The head of the
institution has the responsibility to make arrangements to prevent such incidents
by ensuring prompt action by the Local Bodies in control of the institution.
13) The Head of the institution / Local body in control of the institution has the
responsibility for ensuring the availability of the materials necessary for the conduct
of postmortem examinations, keeping the mortuary and equipments used in them
clean and disinfected in the proper way and collection, packing and sealing of the
viscera and other material objects. The public should not be made to buy any
material necessary for the conduct of postmortem examination or any of its allied
works.
14) In institutions where Police Surgeons are working, they will conduct all postmortem
examinations. In other institutions the Resident Medical Officer of the institution will
post the Medical Officers on a rotation basis for the conduct of postmortem
examination. In institutions with only one Police Surgeon attached to it and on days
on which the Police Surgeon is on leave or out of station due to Court duty or other
reasons, the Resident Medical Officer of the institution will post Medical Officers,
on a rotation basis for the conduct of the postmortem examination.
15) As far as possible, postmortem examinations should only be conducted inside a
mortuary with prescribed facilities. In exceptional situations and only when it
becomes absolutely necessary, all such postmortem examinations at site and
examination of exhumed dead bodies should be done by the Police Surgeons. All
requests for site postmortem examinations should be signed by the Police Officer
in charge of the Police Sub Division where the body is found, specifying the reason
for making such request. There should be adequate ground to believe that some
sort of foul play has occurred in the case, which can only be solved by the police
surgeon visiting the body at the scene. Decomposed state of the dead body to any
extent should not be the sole reason for making a request for postmortem
 examination at site. In any case, the police surgeon has a right to ask the police
officer in charge of the body to make arrangements for the body to be transferred
to the mortuary of the nearest institution authorized to undertake postmortem
examination, for detailed examination of the case, under adequate facilities. In any
situation, when only one Police Surgeon is available, like on holidays, he should
not be asked to leave the mortuary unmanned and without any staff, for the sake of
a postmortem examination at site or scene examination. The investigating officers
should make alternative arrangements or postpone such examinations to the next
working day, so as to avoid delay in conducting postmortem examinations on
bodies brought to the mortuary on that day.
16) All cases of murder, suspicious deaths (should be recorded as suspicious in
column No.7 of requisition for postmortem examination in KPF 102), complicated
cases, cases where no obvious cause of death is revealed at inquest as per
column No.8 of KPF 102 and all cases where inquest was held by a Magistrate, as
per Sec.176 of Cr.P.C., should be done by the police surgeons. Medical officers
working in institutions authorized to undertake medico-legal postmortem
examination will have the right to refer or redirect the requisition for postmortem
examination in all such cases to the nearest Police Surgeon.
17) The time for conducting postmortem examinations is fixed between 09.00am and
05.00pm. The minimum time required to conduct one medico-legal postmortem
examination is one hour. When there is more than one case of postmortem
examination in an institution, the requisition for which was received first should be
begun first. Except in situations where postmortem examinations are being done
so that all the tables are occupied and other cases waiting or the Police Surgeon /
Medical Officer is engaged in other unavoidable emergency official duty,
postmortem examination for which requisition is received should be begun
immediately. A delay of more than one hour to begin the postmortem examination
should be avoided at any cost. Since the minimum time required for conducting
one postmortem examination is one hour, no medical officer shall accept
requisition for postmortem examination after 04.00pm. However, postmortem
examinations may be undertaken at any time in the following situations –
 1. In mass casualties where more than five persons died in one accident and a
Government Order, based on the decision of a Special Cabinet meeting with
at least two Ministers of the State Government taking part in the meeting,
instructing the nearest Police Surgeon / Medical Officer, to undertake the
postmortem examination of the persons died in the particular incident, beyond
the prescribed time limit.
2. In Law and Order situations where, based on the report of the Superintendent
of Police or District Magistrate of the particular district where such situation
prevails, a Special Cabinet meeting with at least two Ministers of the State
Government taking part in the meeting, instructing the nearest Police Surgeon
/ Medical Officer, to undertake the postmortem examination of the person(s),
beyond the prescribed time limit.
The presence of two Ministers of the State Government at the scene of such
casualty and both concurring on the necessity for the immediate disposal of dead
bodies to avoid Law and Order or other such adverse consequences, and that
opinion transmitted to the District Magistrate or District Superintendent Police will
also suffice for the purpose of Special Cabinet Decision. In all such situations, the
doctor who has conducted such postmortem examination(s) will be exempted from
the burden of substantiating the reasons for violating the rules of the State
Government, in this regard.
18) Before beginning postmortem examination, the medical officer should issue the
body receipt to the charge police constable. He should then fill in the details in the
relevant columns of the Postmortem detailed Notes and should get the signature of
the charge police constable to the effect of identifying the dead body as to be that
of the deceased person involved in the particular crime and for which the
requisition is obtained.
19) Medico-legal postmortem examination is a complete autopsy and the medical
officer should follow the prescribed procedure to ensure completeness in the
examination. He should do the dissection himself. He should note all the external
findings and the findings of the dissection in the detailed notes. On completion of
the postmortem examination the medical officer shall release the dead body to the
charge police constable and should obtain his signature to that effect in the
 postmortem detailed notes. A detailed description regarding the guidelines for
conducting the postmortem examination, incorporating those prescribed as per
G.O. (MS) 122/84, Home (H) Department, Dated 04-09-1984 and with necessary
modifications is appended as Annexure – II to this code. Medical Officers should
follow those guidelines, for the conduct of medico-legal postmortem examinations.
20) Apart from the cases mentioned as to be done by the Police Surgeons, a medical
officer can refer a case of postmortem examination to a police surgeon, based on
any finding that makes him convinced that the examination of the body by a
specialist is mandatory to arrive at a correct conclusion. He should then consult the
Head of the institution. With his concurrence, he can refer the case to a police
surgeon, in the prescribed format. In such cases, the head of the institution should
provide free ambulance service at the cost of the funds at his disposal, for the
transportation of the body to the nearest police surgeon’s unit.
21) The medical officer should give a statement to the investigating police officer,
incorporating the relevant positive findings in the case and his interpretations. This
statement should be taken in writing by the investigating police officer. The medical
officer shall not sign this statement, taken as per the provisions of Section 161 of
Cr.P.C. (162 Statement) Since the Police Surgeons / Medical Officers doing
postmortem examination are expert witness in the official capacity, a copy of the
statement may be given to them for future reference before appearing in the Court
to give evidence.
22) Viscera and other material objects collected at the time of postmortem examination
should be kept under safe custody till the same is forwarded to the Chemical
Examiner. Ideally, this should be done immediately upon completion of the
postmortem examination and through the charge police constable. Police surgeons
should have an office seal and a metallic seal in their office, prescribed for them as
part of this code. In all instances where such immediate forwarding of the viscera
and other material objects is not possible, the fact that viscera and other material
objects are preserved should be intimated to the investigating officer. On receipt of
such information, the investigating officer should depute a police constable for
transporting the viscera and other material objects to the laboratory. If he feels that
the chemical analysis of such viscera is not required for the further investigation of
 the case, he may inform the medical officer the same. In any case, the medical
officer is not bound to preserve the viscera in the mortuary for more than three
months from the date of postmortem examination. The medical officer, then can
arrange for the disposal of the viscera and other material objects. In the case of
material objects which have to be forwarded to the Forensic Science Laboratory or
those for DNA profiling etc., such material objects should be immediately handed
over to the Investigating Officer in sealed and labeled packets. The Investigating
Officer should take such packets on a seizure mahessar, preferably citing the staff
assisting postmortem examination as witness to the seizure.
23) The head of the institution should ensure the typewriting of the postmortem
certificate in quadruplicate. The head of the institution should ensure the postal
dispatching of the original of such certificates to the concerned Courts and
duplicate copy to the investigating officer of the case. However, the issue of the
postmortem certificates to the Courts and Police officers may be done by the police
surgeon / medical officer, at any time on a written requisition for the immediate
issue of the same.
24) The quadruplicate should be issued to the legal heirs of the deceased person, on a
No Objection Certificate from the investigating police officer. In any case, the
quadruplicate copy should not be issued before the Court and the investigating
officer had received the certificate. Whenever the authenticity of the copy of
postmortem certificate is required to be certified for the purpose of insurance claim,
it should be done in the prescribed form of application cum certificate of
authenticity of the copy of postmortem certificate.
25) The triplicate copy of the certificate, requisition in KPF 102, detailed notes in the
case, copy of the statement given to the police officer and any other document in
the case should be made into a file, stapled or tied at the top left corner. All such
files of postmortem examinations should be kept in serial order. Police surgeons
will keep those files in their office. The files of postmortem examinations attended
to by other doctors will be kept in the medical record library or in the office as
specified earlier. A doctor who had conducted a postmortem examination has the
right to refer to the files of postmortem examination conducted by him, for the
 purpose of any reference as part of official duty, including giving evidence in the
case in the Court of Law.
26) The Honorarium for conducting postmortem examination should be disbursed on a
monthly basis. The head of the institution should sanction the amount to the doctor
and assisting staff who had actually conducted the postmortem examination. In
cases where postmortem examination was referred to the police surgeon, the
doctor who referred is not eligible for the honorarium. In cases where a team of
doctors attended to one postmortem examination, the doctor who led the team is
only eligible for the honorarium. Between the two assisting staff, higher amount of
the honorarium should always be given to the lower category of staff. Honorarium
for typewriting the postmortem certificate should only be sanctioned to the staff
who have actually typewritten the certificate.
27) In cases where viscera and other material objects were sent for chemical analysis,
the report of chemical analysis should be immediately transmitted to the doctor
who conducted postmortem examination in the case, on receipt of it by the
institution. The doctor should prepare the draft of the final postmortem certificate,
incorporating his final opinion regarding the case in the prescribed format. The
Typist / Confidential Assistant assigned with the job of typing the postmortem
certificate should typewrite the final postmortem certificate in quadruplicate. The
issue of these certificates will be made in the same line as that of the postmortem
certificates.
 Annexure – 1
Formats for Medico-legal Certification

1
 ORIGINAL
ACCIDENT REGISTER – CUM – WOUND CERTIFICATE

1. Serial No……………………. 2. Date and time of examination…………….…………………

3. Name………………………………………………………..Age :…….years. Sex : male/female
4. Address………………….…………………………………………………………………………
…………..…………………………………………………………………………………………
5. Identification marks: (1)………………….……………………………………………………….
(2)……………………………………..……………………………………
6. Brought by (Name & address)…………………………………..……………….………………...
7. Requisition (if any) from…………………….…………………………………………………….
8. History and alleged cause of injury………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
9. History was stated by the injured / ……………………………………………………………..**
10.Details of injuries:

11. Findings of physical examination :……………………………………………………………..

………………………………………………………………………………………………………
………………………………………………………………………………………………………
12. Number of additional sheets if any………….
13. Whether admitted or not: Admitted/Observation/Out patient/Expired in casualty/Referred.**
14. Opinion: Could be / could not be as alleged.** Injuries appeared Fresh / Old.

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :
2
 DUPLICATE
ACCIDENT REGISTER – CUM – WOUND CERTIFICATE

1. Serial No……………………. 2. Date and time of examination…………….…………………

3. Name………………………………………………………..Age :…….years. Sex : male/female
4. Address………………….…………………………………………………………………………
…………..…………………………………………………………………………………………
5. Identification marks: (1)………………….……………………………………………………….
(2)……………………………………..……………………………………
6. Brought by (Name & address)…………………………………..……………….………………...
7. Requisition (if any) from…………………….…………………………………………………….
8. History and alleged cause of injury………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
9. History was stated by the injured / ……………………………………………………………..**
10.Details of injuries:

11. Findings of physical examination :……………………………………………………………..

………………………………………………………………………………………………………
………………………………………………………………………………………………………
12. Number of additional sheets if any………….
13. Whether admitted or not: Admitted/Observation/Out patient/Expired in casualty/Referred.**
14. Opinion: Could be / could not be as alleged.** Injuries appeared Fresh / Old.

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :
3
 TRIPLICATE
ACCIDENT REGISTER – CUM – WOUND CERTIFICATE

1. Serial No……………………. 2. Date and time of examination…………….…………………

3. Name………………………………………………………..Age :…….years. Sex : male/female
4. Address………………….…………………………………………………………………………
…………..…………………………………………………………………………………………
5. Identification marks: (1)………………….……………………………………………………….
(2)……………………………………..……………………………………
6. Brought by (Name & address)…………………………………..……………….………………...
7. Requisition (if any) from…………………….…………………………………………………….
8. History and alleged cause of injury………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
9. History was stated by the injured / ……………………………………………………………..**
10.Details of injuries:

11. Findings of physical examination :……………………………………………………………..

………………………………………………………………………………………………………
………………………………………………………………………………………………………
12. Number of additional sheets if any………….
13. Whether admitted or not: Admitted/Observation/Out patient/Expired in casualty/Referred.**
14. Opinion: Could be / could not be as alleged.** Injuries appeared Fresh / Old.

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

4
 ORIGINAL

POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address ………………………………………………………….
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
-----------------------------------------------------------------------------------------------------------------
POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address …………………………………………………………
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
-----------------------------------------------------------------------------------------------------------------
POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address …………………………………………………………
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
----------------------------------- --------------------------------------------- ------------------------------------- -------------------
*Strike off whichever is not applicable
5
 DUPLICATE

POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address ………………………………………………………….
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
-----------------------------------------------------------------------------------------------------------------
POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address …………………………………………………………
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
-----------------------------------------------------------------------------------------------------------------
POLICE INTIMATION
To : The S.I./SHO of …………………………………………………Police station.
I write to inform you that a person by name ……………………………………………………
male/female, aged ……..years, address …………………………………………………………
……………………………………………………………………………………………………
came to this institution with alleged history of ………………………………………………… .
He/she is being treated as inpatient in…………ward / outpatient / referred / expired in casualty.*
Please do the needful.
Signature :
Date : …………………….. Name : ………………………………….
Place :…………………….. Designation : ……………………………….
Name of institution :……………………………………………………………………………
----------------------------------- --------------------------------------------- ------------------------------------- -------------------
*Strike off whichever is not applicable

6
 ORIGINAL

PROFORMA FOR RECORDING DYING DECLARATION BY A MEDICAL PRACTITIONER

I, Dr……………………………………………..Son/Daughter of ………………………………………,
working as ………………………………………………………………………………..………, residing at
…………………………………………………………………………………………………………………,
in presence of witnesses (1) …………………………………..Son/Daughter of……………………………
residing at………………………………………………………………………………………………………
and (2)…………………………………………..Son/Daughter of………………………………. residing at
…………….. ……………… shall record the dying declaration of ………………………………………...
male/female aged ……years, S/o ……………………………………………residing at …………….………
………………………………………………………………………………….at…………………am/pm, on
(date)…………………………., at (place)………………………… …………………………………………
in the word by word order as narrated by the declarant.
Before recording this dying declaration, I have examined the declarant and found that his/her condition
is critical and he/she may die any time hereafter, in spite of the life saving treatment being given to him/her.
I have also thoroughly examined his/her level of consciousness, orientation of time and space, memory and
other mental faculties and I hereby certify that the declarant is in possession of a sound mind to deliver his
dying declaration. The words of the declarant as said by him are …………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………..……………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
In order to clarify the points as revealed by the answers to the questions recorded in continuation to this, I
asked the following questions to which the declarant gave the answers, which are recorded in that sequence
Question:………………………………………………………………………………………………………
………………………………………………………………………………………………………………….
Answer:……………………………………..…………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
I Dr. ………………………………………..…..certify that the above declaration was recorded by me and
I also certify that the declarant ………………..……………………..maintained his/her sound state of mind
throughout the dictation of his/her declaration. The recording ended at ……………..am/pm on ……………
Signature:
Name & address of the Medical Practitioner:

Read over to me and found to be correct Signature:

(Should be translated into declarant’s mother tongue) Name & address of the declarant :

Recorded and signed in my presence.

Signature, Name &

address of First witness:

Signature, Name &

address of Second witness:
7
 DUPLICATE

PROFORMA FOR RECORDING DYING DECLARATION BY A MEDICAL PRACTITIONER

I, Dr……………………………………………..Son/Daughter of ………………………………………,
working as ………………………………………………………………………………..………, residing at
…………………………………………………………………………………………………………………,
in presence of witnesses (1) …………………………………..Son/Daughter of……………………………
residing at………………………………………………………………………………………………………
and (2)…………………………………………..Son/Daughter of………………………………. residing at
…………….. ……………… shall record the dying declaration of ………………………………………...
male/female aged ……years, S/o ……………………………………………residing at …………….………
………………………………………………………………………………….at…………………am/pm, on
(date)…………………………., at (place)………………………… …………………………………………
in the word by word order as narrated by the declarant.
Before recording this dying declaration, I have examined the declarant and found that his/her condition
is critical and he/she may die any time hereafter, in spite of the life saving treatment being given to him/her.
I have also thoroughly examined his/her level of consciousness, orientation of time and space, memory and
other mental faculties and I hereby certify that the declarant is in possession of a sound mind to deliver his
dying declaration. The words of the declarant as said by him are …………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………..……………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
In order to clarify the points as revealed by the answers to the questions recorded in continuation to this, I
asked the following questions to which the declarant gave the answers, which are recorded in that sequence
Question:………………………………………………………………………………………………………
………………………………………………………………………………………………………………….
Answer:……………………………………..…………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
I Dr. ………………………………………..…..certify that the above declaration was recorded by me and
I also certify that the declarant ………………..……………………..maintained his/her sound state of mind
throughout the dictation of his/her declaration. The recording ended at ……………..am/pm on ……………
Signature:
Name & address of the Medical Practitioner:

Read over to me and found to be correct Signature:

(Should be translated into declarant’s mother tongue) Name & address of the declarant :

Recorded and signed in my presence.

Signature, Name &

address of First witness:

Signature, Name &

address of Second witness:

8
 ORIGINAL
TREATMENT / DISCHARGE CERTIFICATE
(Issued In Continuation To The Accident Register-Cum-Wound Certificate)
1. Serial No., Date & Name of Institution of the Wound Certificate…………………………...……
……………………………………………………………………………………………………..
2. Name………………………………………………………. Age :…….years. Sex : male/female
3. Address………………….…………………………………………………………………………
…………………………………………………………………………………………………….
4. IP No……………..Date of admission…....………………..Date of discharge…..….……………
5. Name of the doctor who treated the patient*..…………………………………………………….
6. Condition at admission………………………………………………………………………….....
………………………………………………………………………………………………………
……………………………………………………………………………………………………….
7. Results of clinical investigations if any……..……………………………………………………..
…..…………………………………………………………………………………………………….
….…………………………………………………………………………………………………….
……………………………………………………………………………………………………..…
……………………………………………………………………………………………………….
8. Injuries diagnosed other than those noted in the Wound Certificate, if any……….……………..
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
9. Details of treatment given, including those of surgical and other procedures if any……………..
…………………………………………………………………………………………………….
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
10.Condition at discharge…………………………………………………………………………….
….…………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
11.Advise given at the time of discharge regarding further treatment if necessary………………….
….…………………………………………………………………………………………………….
.……………………………………………………………………………………………………….
12.Remarks if any :…………………………………………………………………………………
…….…………………………………………………………………………………………………
……………………………………………………………………………………………………...…

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
* The name in both these columns should be same. ** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

9
 DUPLICATE
TREATMENT / DISCHARGE CERTIFICATE
(Issued In Continuation To The Accident Register-Cum-Wound Certificate)
1. Serial No., Date & Name of Institution of the Wound Certificate…………………………...……
……………………………………………………………………………………………………..
2. Name………………………………………………………. Age :…….years. Sex : male/female
3. Address………………….…………………………………………………………………………
…………………………………………………………………………………………………….
4. IP No……………..Date of admission…....………………..Date of discharge…..….……………
5. Name of the doctor who treated the patient*..…………………………………………………….
6. Condition at admission………………………………………………………………………….....
………………………………………………………………………………………………………
……………………………………………………………………………………………………….
7. Results of clinical investigations if any……..……………………………………………………..
…..…………………………………………………………………………………………………….
….…………………………………………………………………………………………………….
……………………………………………………………………………………………………..…
……………………………………………………………………………………………………….
8. Injuries diagnosed other than those noted in the Wound Certificate, if any……….……………..
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
9. Details of treatment given, including those of surgical and other procedures if any……………..
…………………………………………………………………………………………………….
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
10.Condition at discharge…………………………………………………………………………….
….…………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
11.Advise given at the time of discharge regarding further treatment if necessary………………….
….…………………………………………………………………………………………………….
.……………………………………………………………………………………………………….
12.Remarks if any :…………………………………………………………………………………
…….…………………………………………………………………………………………………
……………………………………………………………………………………………………...…

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
* The name in both these columns should be same. ** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

10
 TRIPLICATE
TREATMENT / DISCHARGE CERTIFICATE
(Issued In Continuation To The Accident Register-Cum-Wound Certificate)
1. Serial No., Date & Name of Institution of the Wound Certificate…………………………...……
……………………………………………………………………………………………………..
2. Name………………………………………………………. Age :…….years. Sex : male/female
3. Address………………….…………………………………………………………………………
…………………………………………………………………………………………………….
4. IP No……………..Date of admission…....………………..Date of discharge…..….……………
5. Name of the doctor who treated the patient*..…………………………………………………….
6. Condition at admission………………………………………………………………………….....
………………………………………………………………………………………………………
……………………………………………………………………………………………………….
7. Results of clinical investigations if any……..……………………………………………………..
…..…………………………………………………………………………………………………….
….…………………………………………………………………………………………………….
……………………………………………………………………………………………………..…
……………………………………………………………………………………………………….
8. Injuries diagnosed other than those noted in the Wound Certificate, if any……….……………..
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
9. Details of treatment given, including those of surgical and other procedures if any……………..
…………………………………………………………………………………………………….
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
10.Condition at discharge…………………………………………………………………………….
….…………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
11.Advise given at the time of discharge regarding further treatment if necessary………………….
….…………………………………………………………………………………………………….
.……………………………………………………………………………………………………….
12.Remarks if any :…………………………………………………………………………………
…….…………………………………………………………………………………………………
……………………………………………………………………………………………………...…

Signature :…………………………………..……
Date :…………………….. Name :……………………..…………………
Place :…………………….. Designation:………………….…………………...
Name of Institution :……………………………………………………………………………………………
* The name in both these columns should be same. ** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

11
 ORIGINAL
SL. No………………….. Date…………….…..………
CERTIFICATE OF DRUNKENNESS
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of drunkenness of ………...………………..…………………
…………………………………….. aged……….years and accompanied by HC / PC No. …………………

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………

Whether under arrest or not (to be specified in requisition) : Yes / No

Date & time of arrest (as specified in the requisition) : ………………………………..……………………
Date & time of examination. : ………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) relevant to consumption of alcohol :………………………………….…………………………………
(b) relevant to illness if any : ……………………………………………..…………………………………

Smell of alcohol in breath : Present / Absent.

General appearance & behavior.
(a) Clothing : Decently dressed / Disordered / Soiled / Torn.
(b) General disposition : Calm / Talkative / Abusive / Aggressive.
(c) Speech : Normal / Thick and slurred / incoherent.
Eyes. (a) Conjunctiva : Normal / Congested. (b) Pupils : Normal / Dilated / Sluggishly reacting.
Higher functions
(a) Self control : Normal / Impaired. (b) Memory : Normal / impaired.
(c) Orientation of time & space : Normal / impaired. (d) Reaction time : Normal / Delayed.
Muscular co-ordination
(a)Gait : Normal / Unsteady / Unable to stand upright.
(b) Finger nose test : Positive / Negative.
Systemic examination findings :
Pulse : ……./min. B.P. : ………………….mm of Hg. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive / Negative.
Any other findings / Injuries on the body :…………………………………………………………………
………………………………………………………………………………………………………………

Smell of alcohol in breath : Persisting / Not persisting.

Special examination (Blood & Urine) : Preserved / Not preserved.

Opinion :
1) There is nothing on examination to suggest that the person has consumed alcohol.
2) The person examined has consumed alcohol, but is not under the influence of alcohol.
3) The person examined has consumed alcohol and is under the influence of alcohol.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
12
 DUPLICATE
SL. No………………….. Date…………….…..………
CERTIFICATE OF DRUNKENNESS
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of drunkenness of ………...………………..…………………
…………………………………….. aged……….years and accompanied by HC / PC No. …………………

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………

Whether under arrest or not (to be specified in requisition) : Yes / No

Date & time of arrest (as specified in the requisition) : ………………………………..……………………
Date & time of examination. : ………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) relevant to consumption of alcohol :………………………………….…………………………………
(b) relevant to illness if any : ……………………………………………..…………………………………

Smell of alcohol in breath : Present / Absent.

General appearance & behavior.
(a) Clothing : Decently dressed / Disordered / Soiled / Torn.
(b) General disposition : Calm / Talkative / Abusive / Aggressive.
(c) Speech : Normal / Thick and slurred / incoherent.
Eyes. (a) Conjunctiva : Normal / Congested. (b) Pupils : Normal / Dilated / Sluggishly reacting.
Higher functions
(a) Self control : Normal / Impaired. (b) Memory : Normal / impaired.
(c) Orientation of time & space : Normal / impaired. (d) Reaction time : Normal / Delayed.
Muscular co-ordination
(a)Gait : Normal / Unsteady / Unable to stand upright.
(b) Finger nose test : Positive / Negative.
Systemic examination findings :
Pulse : ……./min. B.P. : ………………….mm of Hg. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive / Negative.
Any other findings / Injuries on the body :…………………………………………………………………
………………………………………………………………………………………………………………

Smell of alcohol in breath : Persisting / Not persisting.

Special examination (Blood & Urine) : Preserved / Not preserved.

Opinion :
1) There is nothing on examination to suggest that the person has consumed alcohol.
2) The person examined has consumed alcohol, but is not under the influence of alcohol.
3) The person examined has consumed alcohol and is under the influence of alcohol.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
13
 TRIPLICATE
SL. No………………….. Date…………….…..………
CERTIFICATE OF DRUNKENNESS
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of drunkenness of ………...………………..…………………
…………………………………….. aged……….years and accompanied by HC / PC No. …………………

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………

Whether under arrest or not (to be specified in requisition) : Yes / No

Date & time of arrest (as specified in the requisition) : ………………………………..……………………
Date & time of examination. : ………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) relevant to consumption of alcohol :………………………………….…………………………………
(b) relevant to illness if any : ……………………………………………..…………………………………

Smell of alcohol in breath : Present / Absent.

General appearance & behavior.
(a) Clothing : Decently dressed / Disordered / Soiled / Torn.
(b) General disposition : Calm / Talkative / Abusive / Aggressive.
(c) Speech : Normal / Thick and slurred / incoherent.
Eyes. (a) Conjunctiva : Normal / Congested. (b) Pupils : Normal / Dilated / Sluggishly reacting.
Higher functions
(a) Self control : Normal / Impaired. (b) Memory : Normal / impaired.
(c) Orientation of time & space : Normal / impaired. (d) Reaction time : Normal / Delayed.
Muscular co-ordination
(a)Gait : Normal / Unsteady / Unable to stand upright.
(b) Finger nose test : Positive / Negative.
Systemic examination findings :
Pulse : ……./min. B.P. : ………………….mm of Hg. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive / Negative.
Any other findings / Injuries on the body :…………………………………………………………………
………………………………………………………………………………………………………………

Smell of alcohol in breath : Persisting / Not persisting.

Special examination (Blood & Urine) : Preserved / Not preserved.

Opinion :
1) There is nothing on examination to suggest that the person has consumed alcohol.
2) The person examined has consumed alcohol, but is not under the influence of alcohol.
3) The person examined has consumed alcohol and is under the influence of alcohol.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
14
 Medico-legal Register

Ref. ML. No/…………/…………….. Date :………………………….

Name of the person :…………………………………………….Age……..years Sex:Male/Female

Address :……………………………………………………………………………………………

……………………………………………………………………………………………………….

Ref. Crime No……………………..of ……………………..………………………..police station.

Requisition from :…………………………………………………………………………………..

…………………………………………………………..……………Dated………………………..

Examination requested :……………………………………………………………………………..

Name & Designation of Medical Officer who conducted the examination :……………………….

………………………………………………………………………………………………………..

Dated signature of the Medical Officer :

-------------------------------------------------------------- -------------------------------------------------------

Ref. ML. No./…………/…………….. Date :………………………….

Name of the person :…………………………………………….Age……..years Sex:Male/Female

Address :……………………………………………………………………………………………

……………………………………………………………………………………………………….

Ref. Crime No……………………..of ……………………..………………………..police station.

Requisition from :…………………………………………………………………………………..

…………………………………………………………..……………Dated………………………..

Examination requested :……………………………………………………………………………..

Name & Designation of Medical Officer who conducted the examination :……………………….

………………………………………………………………………………………………………..

Dated signature of the Medical Officer :

15
 ORIGINAL
Ref. No. ML/MASO……………………. Date :……………………….
Report of examination of a male accused in sexual offence (including Potency)
Requisition dated…………………….. was received at ……………………….on………………………….,
from the………………………………………………………………. for examination including potency of
………………………………….…………..............………………………… aged……….years involved in
crime No…………………of …………………………………….……………………………..Police station.
1. Name & Address of the subject :…………………………………………………………………………
………………………………………………………………………………………………………………
2. Age :………..years 3. Accompanied by (name & address) ………………………………………………
4. Consent :……………………………………………………………………………………………………
………………………………………………………………………………………………………………
5.Date and time of commencement of examination : ……………………………………………….
6. Marks of identification : (1)…………………………………………………………………………………
(2)……………………………………………………………………………………………………………
7. Clinical history: History of any diseases or trauma which may affect potency: Present / Not present.
If present, details:…………………………………………………………………………………………
8. History of sexual development: …………………………………………………………………………..
9. Marital history: Married / Unmarried. Age of marriage:….years. Whether having children: Yes / No.
10. History and alleged cause of injury (if any) :………………………………………………………………
11.Physical examination: A. General:- Height:………cm. Weight………..kg. Build: Good/Moderate/Poor.
Hair : Normal Adolescent male / Adult male type of hair growth on face & body Present / Absent.
B. Local :- (a) Penis : Present / Absent. Length ………cm Circumference ……..cm (both flaccid state)
Disease /Deformity / Injury (if any): Present / Absent. If present, details…………….………………….
…………………………………………………………………………………………….……………….
Fore skin : Retractable / Non retractable / Circumcised. Smegma deposits on corona: Present / Absent.
Sensations : Normal / Abnormal. Urethral discharge or tenderness on palpation: Present / Absent.
(b) Scrotum : Pendulous / Non-pendulous. Right testis :present /absent. Left testis : Present/absent.
Development of testis : Small / Medium / Adult size. Sensations & Reflexes: Normal/Impaired.
Disease / Deformity / Injury (if any)……………………………………………………………..…………
C. Systemic examination : Pulse…………/min. BP………………….mm of Hg.
Other findings ( CVS, CNS, RS, GIS )……………………………………………….…………………
D. Injuries on the body if any :……………………………………………………………………………..
………………………………………………………….………………………………………………..
…………………………………………………………..……………………………………………….
…………………………………………………………………………………………………………..
The examination concluded at ……………………….…am/pm on…………………………………....
12. Material objects preserved** : (a) Nail clippings (b) Scalp Hair (cut) sample (b) Pubic hair combings
(c) Pubic hairs (cut) (d) Penile Swabs taken with cotton just wetted in water & shade dried ( to look
for vaginal epithelial cells & for DNA profiling) (e) Penile washings in normal saline
(f) Blood for DNA profiling (g) others if any ………………………………………………….…………
………………………………………………………………………………………………………….
OPINION:
* There is nothing to suggest that the above person is incapable of performing the sexual act.
* The above subject may be incapable of performing sexual act.
* There is evidence / No evidence of Recent Sexual Act ( Based on results of Laboratory examinations)
* Opinion as to cause of injury : Could be as alleged / Could not be as alleged
* Other if any :……………………………………………………………………………………………….
REASONS FOR CONCLUSIONS ARRIVED AT :………………………………………………………..
………………………………………………………………………………………………………………….

Signature :……………………..……
Date :…………………….. Name :………..…………………
Place :…………………….. Designation:………………..……….
Name of institution :……………………………………………………………………………………………
Received the certificate : ……………………………………..(Signature, Name & P.C. No………………..)
*Delete whichever is not applicable. **All need not be preserved if examined after 72hours of alleged incident
16
 DUPLICATE
Ref. No. ML/MASO……………………. Date :……………………….
Report of examination of a male accused in sexual offence (including Potency)
Requisition dated…………………….. was received at ……………………….on………………………….,
from the………………………………………………………………. for examination including potency of
………………………………….…………..............………………………… aged……….years involved in
crime No…………………of …………………………………….……………………………..Police station.
1. Name & Address of the subject :…………………………………………………………………………
………………………………………………………………………………………………………………
2. Age :………..years 3. Accompanied by (name & address) ………………………………………………
4. Consent :……………………………………………………………………………………………………
………………………………………………………………………………………………………………
5.Date and time of commencement of examination : ………………………………………………..
6. Marks of identification : (1)…………………………………………………………………………………
(2)……………………………………………………………………………………………………………
7. Clinical history: History of any diseases or trauma which may affect potency: Present / Not present.
If present, details:…………………………………………………………………………………………
8. History of sexual development: …………………………………………………………………………..
9. Marital history: Married / Unmarried. Age of marriage:….years. Whether having children: Yes / No.
10. History and alleged cause of injury (if any) :………………………………………………………………
11.Physical examination: A. General:- Height:………cm. Weight………..kg. Build: Good/Moderate/Poor.
Hair : Normal Adolescent male / Adult male type of hair growth on face & body Present / Absent.
B. Local :- (a) Penis : Present / Absent. Length ………cm Circumference ……..cm (both flaccid state)
Disease /Deformity / Injury (if any): Present / Absent. If present, details…………….………………….
…………………………………………………………………………………………….……………….
Fore skin : Retractable / Non retractable / Circumcised. Smegma deposits on corona: Present / Absent.
Sensations : Normal / Abnormal. Urethral discharge or tenderness on palpation: Present / Absent.
(b) Scrotum : Pendulous / Non-pendulous. Right testis :present /absent. Left testis : Present/absent.
Development of testis : Small / Medium / Adult size. Sensations & Reflexes: Normal/Impaired.
Disease / Deformity / Injury (if any)……………………………………………………………..…………
C. Systemic examination : Pulse…………/min. BP………………….mm of Hg.
Other findings ( CVS, CNS, RS, GIS )……………………………………………….…………………
D. Injuries on the body if any :……………………………………………………………………………..
………………………………………………………….………………………………………………..
…………………………………………………………..……………………………………………….
…………………………………………………………………………………………………………..
The examination concluded at ……………………….…am/pm on…………………………………....
12. Material objects preserved** : (a) Nail clippings (b) Scalp Hair (cut) sample (b) Pubic hair combings
(c) Pubic hairs (cut) (d) Penile Swabs taken with cotton just wetted in water & shade dried ( to look
for vaginal epithelial cells & for DNA profiling) (e) Penile washings in normal saline
(f) Blood for DNA profiling (g) others if any ………………………………………………….…………
………………………………………………………………………………………………………….
OPINION:
* There is nothing to suggest that the above person is incapable of performing the sexual act.
* The above subject may be incapable of performing sexual act.
* There is evidence / No evidence of Recent Sexual Act ( Based on results of Laboratory examinations)
* Opinion as to cause of injury : Could be as alleged / Could not be as alleged
* Other if any :……………………………………………………………………………………………….
REASONS FOR CONCLUSIONS ARRIVED AT :………………………………………………………..
………………………………………………………………………………………………………………….

Signature :……………………..……
Date :…………………….. Name :………..…………………
Place :…………………….. Designation:………………..……….
Name of institution :……………………………………………………………………………………………
Received the certificate : ……………………………………..(Signature, Name & P.C. No………………..)
*Delete whichever is not applicable. **All need not be preserved if examined after 72hours of alleged incident
17
 TRIPLICATE
Ref. No. ML/MASO……………………. Date :……………………….
Report of examination of a male accused in sexual offence (including Potency)
Requisition dated…………………….. was received at ……………………….on………………………….,
from the………………………………………………………………. for examination including potency of
………………………………….…………..............………………………… aged……….years involved in
crime No…………………of …………………………………….……………………………..Police station.
1. Name & Address of the subject :…………………………………………………………………………
………………………………………………………………………………………………………………
2. Age :………..years 3. Accompanied by (name & address) ………………………………………………
4. Consent :……………………………………………………………………………………………………
………………………………………………………………………………………………………………
5.Date and time of commencement of examination : ………………………………………………..
6. Marks of identification : (1)…………………………………………………………………………………
(2)……………………………………………………………………………………………………………
7. Clinical history: History of any diseases or trauma which may affect potency: Present / Not present.
If present, details:…………………………………………………………………………………………
8. History of sexual development: …………………………………………………………………………..
9. Marital history: Married / Unmarried. Age of marriage:….years. Whether having children: Yes / No.
10. History and alleged cause of injury (if any) :………………………………………………………………
11.Physical examination: A. General:- Height:………cm. Weight………..kg. Build: Good/Moderate/Poor.
Hair : Normal Adolescent male / Adult male type of hair growth on face & body Present / Absent.
B. Local :- (a) Penis : Present / Absent. Length ………cm Circumference ……..cm (both flaccid state)
Disease /Deformity / Injury (if any): Present / Absent. If present, details…………….………………….
…………………………………………………………………………………………….……………….
Fore skin : Retractable / Non retractable / Circumcised. Smegma deposits on corona: Present / Absent.
Sensations : Normal / Abnormal. Urethral discharge or tenderness on palpation: Present / Absent.
(b) Scrotum : Pendulous / Non-pendulous. Right testis :present /absent. Left testis : Present/absent.
Development of testis : Small / Medium / Adult size. Sensations & Reflexes: Normal/Impaired.
Disease / Deformity / Injury (if any)……………………………………………………………..…………
C. Systemic examination : Pulse…………/min. BP………………….mm of Hg.
Other findings ( CVS, CNS, RS, GIS )……………………………………………….…………………
D. Injuries on the body if any :……………………………………………………………………………..
………………………………………………………….………………………………………………..
…………………………………………………………..……………………………………………….
…………………………………………………………………………………………………………..
The examination concluded at ……………………….…am/pm on…………………………………....
12. Material objects preserved** : (a) Nail clippings (b) Scalp Hair (cut) sample (b) Pubic hair combings
(c) Pubic hairs (cut) (d) Penile Swabs taken with cotton just wetted in water & shade dried ( to look
for vaginal epithelial cells & for DNA profiling) (e) Penile washings in normal saline
(f) Blood for DNA profiling (g) others if any ………………………………………………….…………
………………………………………………………………………………………………………….
OPINION:
* There is nothing to suggest that the above person is incapable of performing the sexual act.
* The above subject may be incapable of performing sexual act.
* There is evidence / No evidence of Recent Sexual Act ( Based on results of Laboratory examinations)
* Opinion as to cause of injury : Could be as alleged / Could not be as alleged
* Other if any :……………………………………………………………………………………………….
REASONS FOR CONCLUSIONS ARRIVED AT :………………………………………………………..
………………………………………………………………………………………………………………….

Signature :……………………..……
Date :…………………….. Name :………..…………………
Place :…………………….. Designation:………………..……….
Name of institution :……………………………………………………………………………………………
Received the certificate : ……………………………………..(Signature, Name & P.C. No………………..)
*Delete whichever is not applicable. **All need not be preserved if examined after 72hours of alleged incident
18
 ORIGINAL
Page 1
Ref. ML. No./FVSA : ………………….. Date : ………………….…

REPORT OF EXAMINATION OF A FEMALE VICTIM OF SEXUAL ASSAULT

Name :………………………………………..…………………………………………..Age :…………years

Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and brought or accompanied by (Name & Address.) …………….…...……………………...………………..
………………………………………………………………………………………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time of commencement & place of examination…………..…………..………………………………..
Identification marks :
(1)………………………………………………………………..……………………………………………..
(2)………………………...…………………………………………………………………………………….
Marital status : Married / Unmarried. Educational status :………………………………………….
Occupation :……………...…………………………………………………..………………………
Signature, name and designation of female witness if any ;…………………………………………
………………………………………………………………………………………………………..
History related to the incident (as stated by subject / …………………………………………………….) :
!) Date, time and place of alleged act :………………………………………………………………………..
………………………………………………………………………………………………………………
2) State of consciousness at the time of incident :…………………………………………………………….
………………………………………………………………………………………………………………
3) Number and name(s) of person(s) involved :……………………………………………………………….
……………………………………………………………………………………………………………….
4) Details of position :…………………………………………………………………………………………
……………………………………………………………………………………………………………….
5) Degree of violence used and extent of penetration ;………………………………………………………...
………………………………………………………………………………………………………………
6) Resistance offered and if no resistance offered, reason (s) :………………………………………………..
………………………………………………………………………………………………………………
7) Pain on walking / urination / defecation :…………………………………………………………………..
………………………………………………………………………………………………………………
8) Whether urinated / washed the genital area since the incident :………………………………….…………
9) Reasons for delay in complaint if any :……………………………………………………………………...
……………………………………………………………………………………………………………….
10) Any other information to be conveyed :…………………………………………………………………...
………………………...…………………………………………………………………………………….
Sexual history (Previous experience / frequency / date of last sexual act)……………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
Menstrual history : Age of menarche :………years / Not attained / Menopause attained.
Periods : Regular / Irregular / NA Whether menstruating now : Yes/No/NA.
Date of Last Menstrual Period : …………………………………………………..…………………………
Other relevant history if any :………………………………………………………………………………..
………………………………………………………………………………………………………………..
Obstetric history : Whether pregnant now : Yes / No / NA. No of previous pregnancies :………………..
Type of delivery & other details :…………………………………………… ……………………………….
…………………………………………………………………………………………………………………
(To be continued in Page 2)
19
 ORIGINAL
Page 2(Continued from Page 1)

Ref. ML. No./FVSA : ………………….. Date : ………………….…

Physical examination
a) General : 1) Height…………cm. 2) Weight…….kg. 3) Build & nourishment : Good / Moderate / Poor.
4) Clothes : Intact / Disordered / Torn/NA. 5) General Mental condition : Excited / Calm / Depressed.
6) Secondary sexual characters including breasts :………………………………………………………….
……………………………………………………………………………………………………………
b) Local : (1) Condition of pubic hair : Matted / Not matted / ………………………………………………
(2) Appearance of labia / clitoris :…….……………………………………………………………………...
(3) Hymen ; Intact / Torn / Carunculae hymenalis / Absent / Fleshy and elastic / ………………………….
If torn, partial / complete, at ……...…O’clock Position(s) and fresh / infected / healing / old………….
……………………………………………………………………………………………………………
(4) Fourchette : Intact / Torn. Details ………………………………………………………………………
(5) Posterior commissure : Intact / Torn. Details …………………………………………………………..
(6) Vagina : Admits one / two / more fingers. Rugae : Distinct / Not distinct. Discharge : Absent / Present
If present, Normal / blood / yellowish / whitish…………………………………………………………
Injuries in the vagina ;…………………………………………………………………………………
…………………………………………………………………………………………………………..
…………………………………………………………………………………………………………..
(7) Appearance of perineum and thighs :…………………………………………………………………
(8) Others if any :…………………………………………………………………………………………...
c) Injuries on the body (if any) :……………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………….…………………………………
….…………………………………………………………………………………………………………….
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Examination concluded at ……………………………….am/pm on…………………………..
Material Objects preserved : (1) Vaginal smears (2) Vaginal swabs (3) Nail clippings
(4) Loose hair from combings of pubic region (5) Pubic hair samples (cut ) (6) Scalp hair samples (cut)
(6)Urine for pregnancy test (7)Blood to look for sedatives/hypnotics (8) urine to look for sedatives /
hypnotics (9) Clothes. Any other :……………………………………………………………………………
If not preserved, reasons :……………………………………………………………………………………..
OPINION
 Findings of examination are consistent / not inconsistent with the history of alleged sexual assault
 There is evidence / no evidence of recent / past vaginal penetration.
 The injuries on the body could be / could not be suggestive of resistance from the victim.
 There is evidence / no evidence of recent sexual intercourse. (Based on laboratory results)
Reasons for the conclusions arrived at ;……………………………………………………………………..
………………………………………………………………………………………………………………….

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

Received the certificate :………………………………(Signature, name & designation)

20
 DUPLICATE
Page 1
Ref. ML. No./FVSA : ………………….. Date : ………………….…

REPORT OF EXAMINATION OF A FEMALE VICTIM OF SEXUAL ASSAULT

Name :………………………………………..…………………………………………..Age :…………years

Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and brought or accompanied by (Name & Address.) …......……………………...……………………………
………………………………………………………………………………………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time of commencement & place of examination…………..……..……………………………………..
Identification marks :
(1)………………………………………………………………..……………………………………………..
(2)………………………...…………………………………………………………………………………….
Marital status : Married / Unmarried. Educational status :………………………………………….
Occupation :……………...…………………………………………………..………………………
Signature, name and designation of female witness if any ;…………………………………………
………………………………………………………………………………………………………..
History related to the incident (as stated by subject / …………………………………………………….) :
!) Date, time and place of alleged act :………………………………………………………………………..
………………………………………………………………………………………………………………
2) State of consciousness at the time of incident :…………………………………………………………….
………………………………………………………………………………………………………………
3) Number and name(s) of person(s) involved :……………………………………………………………….
……………………………………………………………………………………………………………….
4) Details of position :…………………………………………………………………………………………
……………………………………………………………………………………………………………….
5) Degree of violence used and extent of penetration ;………………………………………………………...
………………………………………………………………………………………………………………
6) Resistance offered and if no resistance offered, reason (s) :………………………………………………..
………………………………………………………………………………………………………………
7) Pain on walking / urination / defecation :…………………………………………………………………..
………………………………………………………………………………………………………………
8) Whether urinated / washed the genital area since the incident :………………………………….…………
9) Reasons for delay in complaint if any :……………………………………………………………………...
……………………………………………………………………………………………………………….
10) Any other information to be conveyed :…………………………………………………………………...
………………………...…………………………………………………………………………………….
Sexual history (Previous experience / frequency / date of last sexual act)……………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
Menstrual history : Age of menarche :………years / Not attained / Menopause attained.
Periods : Regular / Irregular / NA Whether menstruating now : Yes/No/NA.
Date of Last Menstrual Period : …………………………………………………..…………………………
Other relevant history if any :………………………………………………………………………………..
………………………………………………………………………………………………………………..
Obstetric history : Whether pregnant now : Yes / No / NA. No of previous pregnancies :………………..
Type of delivery & other details :…………………………………………… ……………………………….
…………………………………………………………………………………………………………………
(To be continued in Page 2)
21
 DUPLICATE
Page 2(Continued from Page 1)

Ref. ML. No./FVSA : ………………….. Date : ………………….…

Physical examination
a) General : 1) Height…………cm. 2) Weight…….kg. 3) Build & nourishment : Good / Moderate / Poor.
4) Clothes : Intact / Disordered / Torn/NA. 5) General Mental condition : Excited / Calm / Depressed.
6) Secondary sexual characters including breasts :………………………………………………………….
……………………………………………………………………………………………………………
b) Local : (1) Condition of pubic hair : Matted / Not matted / ………………………………………………
(2) Appearance of labia / clitoris :…….……………………………………………………………………...
(3) Hymen ; Intact / Torn / Carunculae hymenalis / Absent / Fleshy and elastic / ………………………….
If torn, partial / complete, at ……...…O’clock Position(s) and fresh / infected / healing / old………….
……………………………………………………………………………………………………………
(4) Fourchette : Intact / Torn. Details ………………………………………………………………………
(5) Posterior commissure : Intact / Torn. Details …………………………………………………………..
(6) Vagina : Admits one / two / more fingers. Rugae : Distinct / Not distinct. Discharge : Absent / Present
If present, Normal / blood / yellowish / whitish…………………………………………………………
Injuries in the vagina ;…………………………………………………………………………………
…………………………………………………………………………………………………………..
…………………………………………………………………………………………………………..
(7) Appearance of perineum and thighs :…………………………………………………………………
(8) Others if any :…………………………………………………………………………………………...
c) Injuries on the body (if any) :……………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………….…………………………………
….…………………………………………………………………………………………………………….
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Examination concluded at ……………………………….am/pm on…………………………..
Material Objects preserved : (1) Vaginal smears (2) Vaginal swabs (3) Nail clippings
(4) Loose hair from combings of pubic region (5) Pubic hair samples (cut ) (6) Scalp hair samples (cut)
(6)Urine for pregnancy test (7)Blood to look for sedatives/hypnotics (8) urine to look for sedatives /
hypnotics (9) Clothes. Any other :……………………………………………………………………………
If not preserved, reasons :……………………………………………………………………………………..
OPINION
 Findings of examination are consistent / not inconsistent with the history of alleged sexual assault
 There is evidence / no evidence of recent / past vaginal penetration.
 The injuries on the body could be / could not be suggestive of resistance from the victim.
 There is evidence / no evidence of recent sexual intercourse. (Based on laboratory results)
Reasons for the conclusions arrived at ;……………………………………………………………………..
………………………………………………………………………………………………………………….

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

Received the certificate :………………………………(Signature, name & designation)

22
 TRIPLICATE
Page 1
Ref. ML. No./FVSA : ………………….. Date : ………………….…

REPORT OF EXAMINATION OF A FEMALE VICTIM OF SEXUAL ASSAULT

Name :………………………………………..…………………………………………..Age :…………years

Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and brought or accompanied by (Name & Address.) …......……………………...……………………………
………………………………………………………………………………………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time of commencement & place of examination………………………………………………………..
Identification marks :
(1)………………………………………………………………..……………………………………………..
(2)………………………...…………………………………………………………………………………….
Marital status : Married / Unmarried. Educational status :………………………………………….
Occupation :……………...…………………………………………………..………………………
Signature, name and designation of female witness if any ;…………………………………………
………………………………………………………………………………………………………..
History related to the incident (as stated by subject / …………………………………………………….) :
!) Date, time and place of alleged act :………………………………………………………………………..
………………………………………………………………………………………………………………
2) State of consciousness at the time of incident :…………………………………………………………….
………………………………………………………………………………………………………………
3) Number and name(s) of person(s) involved :……………………………………………………………….
……………………………………………………………………………………………………………….
4) Details of position :…………………………………………………………………………………………
……………………………………………………………………………………………………………….
5) Degree of violence used and extent of penetration ;………………………………………………………...
………………………………………………………………………………………………………………
6) Resistance offered and if no resistance offered, reason (s) :………………………………………………..
………………………………………………………………………………………………………………
7) Pain on walking / urination / defecation :…………………………………………………………………..
………………………………………………………………………………………………………………
8) Whether urinated / washed the genital area since the incident :………………………………….…………
9) Reasons for delay in complaint if any :……………………………………………………………………...
……………………………………………………………………………………………………………….
10) Any other information to be conveyed :…………………………………………………………………...
………………………...…………………………………………………………………………………….
Sexual history (Previous experience / frequency / date of last sexual act)……………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
Menstrual history : Age of menarche :………years / Not attained / Menopause attained.
Periods : Regular / Irregular / NA Whether menstruating now : Yes/No/NA.
Date of Last Menstrual Period : …………………………………………………..…………………………
Other relevant history if any :………………………………………………………………………………..
………………………………………………………………………………………………………………..
Obstetric history : Whether pregnant now : Yes / No / NA. No of previous pregnancies :………………..
Type of delivery & other details :…………………………………………… ……………………………….
…………………………………………………………………………………………………………………
(To be continued in Page 2)
23
 TRIPLICATE
Page 2(Continued from Page 1)

Ref. ML. No./FVSA : ………………….. Date : ………………….…

Physical examination
a) General : 1) Height…………cm. 2) Weight…….kg. 3) Build & nourishment : Good / Moderate / Poor.
4) Clothes : Intact / Disordered / Torn/NA. 5) General Mental condition : Excited / Calm / Depressed.
6) Secondary sexual characters including breasts :………………………………………………………….
……………………………………………………………………………………………………………
b) Local : (1) Condition of pubic hair : Matted / Not matted / ………………………………………………
(2) Appearance of labia / clitoris :…….……………………………………………………………………...
(3) Hymen ; Intact / Torn / Carunculae hymenalis / Absent / Fleshy and elastic / ………………………….
If torn, partial / complete, at ……...…O’clock Position(s) and fresh / infected / healing / old………….
……………………………………………………………………………………………………………
(4) Fourchette : Intact / Torn. Details ………………………………………………………………………
(5) Posterior commissure : Intact / Torn. Details …………………………………………………………..
(6) Vagina : Admits one / two / more fingers. Rugae : Distinct / Not distinct. Discharge : Absent / Present
If present, Normal / blood / yellowish / whitish…………………………………………………………
Injuries in the vagina ;…………………………………………………………………………………
…………………………………………………………………………………………………………..
…………………………………………………………………………………………………………..
(7) Appearance of perineum and thighs :…………………………………………………………………
(8) Others if any :…………………………………………………………………………………………...
c) Injuries on the body (if any) :……………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………….…………………………………
….…………………………………………………………………………………………………………….
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Examination concluded at ……………………………….am/pm on…………………………..
Material Objects preserved : (1) Vaginal smears (2) Vaginal swabs (3) Nail clippings
(4) Loose hair from combings of pubic region (5) Pubic hair samples (cut ) (6) Scalp hair samples (cut)
(6)Urine for pregnancy test (7)Blood to look for sedatives/hypnotics (8) urine to look for sedatives /
hypnotics (9) Clothes. Any other :……………………………………………………………………………
If not preserved, reasons :……………………………………………………………………………………..
OPINION
 Findings of examination are consistent / not inconsistent with the history of alleged sexual assault
 There is evidence / no evidence of recent / past vaginal penetration.
 The injuries on the body could be / could not be suggestive of resistance from the victim.
 There is evidence / no evidence of recent sexual intercourse. (Based on laboratory results)
Reasons for the conclusions arrived at ;……………………………………………………………………..
………………………………………………………………………………………………………………….

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
** Strike off which is not applicable.
Issued to ……………………………………………………………….. as per his request No. ……….dated …………………….
Date :………………….. Signature of the issuing officer :

Received the certificate :………………………………(Signature, name & designation)

24
 ORIGINAL
Ref. ML / No./ VUSO :……………………….. Date :………………………………
REPORT OF EXAMINATION OF A VICTIM OF UNNATURAL SEXUAL OFFENCE
Name :……………………………………..………………………………Age :…………years. Sex : M / F
Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and accompanied by (Name & Address.) …………….…...……………………...……………………………
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time & place of examination…………..………………………………………………………………..
Identification marks : …………………………………………..……………………………………………..
……………………………...………………………………………………………………………………….
Educational status :……………………………. Occupation …….…………………………………
History related to the incident (as stated by the subject / …………………………………………………) :
………………………………………………… ………………………………………………………………
…………………………………………………………………………………………………………………
Whether changed clothing since the incident: Yes/No/NA. Whether bathed since the incident: Yes/No/NA
Whether washed mouth / had any food or drinks / urinated / defecated since the incident: Yes/No/NA.
Whether having pain on walking/urination/defecation: Yes/No/NA. Any history of vomiting : Yes/No/NA.
Any history of bleeding from anus : Yes/No/NA. Loss of consciousness during / after the incident : Yes/No.
Physical examination
a) General : 1) Height………cm. 2) Weight…….kg. 3) Build : Good/Moderate/Poor. 4) Gait: Painful / Not
4) Mental disposition : Excited / Calm / Depressed. 5) Clothes : Intact / Disordered / Torn/NA.
b) Local : (1) Lips and oral cavity:……………. ……………………………………………………………
(2) Anus : Anal mucosa : Smooth / Thickened. Tears : Present / Absent. If present, Recent / old.
Depression of anus : Present / Not present. Hemorrhoids : Present / Not present.
Stains of blood / Semen / Lubricants : Present / Absent. Anal sphincter : Patulous / Non patulous
Anal sphincter admits one / more finger, with / without pain. Sphincter tone : Retained / Lost
Evidence of STD : Present / Not present. On bimanual lateral traction, anal orifice closes / opens.
Findings of rectal examination with speculum :…………..……………………………………………..
(3) Penis & scrotum :……………………...………………………………………………………………...
(4) Inner thigh regions & pereneum : ……………………..……….……..…………………………………
c) Injuries on the body (if any) : ……………………………………………………………….………………
……………………………………………………………………………………………………………….
………………………………………………………………………………………………………………
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Material objects preserved : (1) Buccal smears and swabs (2)Anal swabs and smears
(3) Swab from skin of thighs. (4) Nail clippings (5) Loose hair from anal region & buttocks
(6) Pubic hairs (cut) sample (7) Blood & Urine to look for sedatives/hypnotics (7) Clothes.
(8) Swabs from suspected stains on the body parts.Others if any : …………………………………………
If not preserved, reasons :…………………………………………………………………………………….
OPINION
 Findings of examination are consistent with / not inconsistent with / not consistent with the
history of alleged unnatural sexual offence.
 There is evidence / no evidence of recent / past anal penetration.
 The injuries on the body could be / could not be suggestive of resistance by the victim.
 There is evidence / no evidence of recent anal / buccal coitus. (Based on laboratory results)

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

25
 DUPLICATE
Ref. ML / No./ VUSO :……………………….. Date :………………………………
REPORT OF EXAMINATION OF A VICTIM OF UNNATURAL SEXUAL OFFENCE
Name :……………………………………..………………………………Age :…………years. Sex : M / F
Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and accompanied by (Name & Address.) …………….…...……………………...……………………………
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time & place of examination…………..………………………………………………………………..
Identification marks : …………………………………………..……………………………………………..
……………………………...………………………………………………………………………………….
Educational status :……………………………. Occupation …….…………………………………
History related to the incident (as stated by the subject / …………………………………………………) :
………………………………………………… ………………………………………………………………
…………………………………………………………………………………………………………………
Whether changed clothing since the incident: Yes/No/NA. Whether bathed since the incident: Yes/No/NA
Whether washed mouth / had any food or drinks / urinated / defecated since the incident: Yes/No/NA.
Whether having pain on walking/urination/defecation: Yes/No/NA. Any history of vomiting : Yes/No/NA.
Any history of bleeding from anus : Yes/No/NA. Loss of consciousness during / after the incident : Yes/No.
Physical examination
a) General : 1) Height………cm. 2) Weight…….kg. 3) Build : Good/Moderate/Poor. 4) Gait: Painful / Not
4) Mental disposition : Excited / Calm / Depressed. 5) Clothes : Intact / Disordered / Torn/NA.
b) Local : (1) Lips and oral cavity:……………. ……………………………………………………………
(2) Anus : Anal mucosa : Smooth / Thickened. Tears : Present / Absent. If present, Recent / old.
Depression of anus : Present / Not present. Hemorrhoids : Present / Not present.
Stains of blood / Semen / Lubricants : Present / Absent. Anal sphincter : Patulous / Non patulous
Anal sphincter admits one / more finger, with / without pain. Sphincter tone : Retained / Lost
Evidence of STD : Present / Not present. On bimanual lateral traction, anal orifice closes / opens.
Findings of rectal examination with speculum :…………..……………………………………………..
(3) Penis & scrotum :……………………...………………………………………………………………...
(4) Inner thigh regions & pereneum : ……………………..……….……..…………………………………
c) Injuries on the body (if any) : ……………………………………………………………….………………
……………………………………………………………………………………………………………….
………………………………………………………………………………………………………………
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Material objects preserved : (1) Buccal smears and swabs (2)Anal swabs and smears
(3) Swab from skin of thighs. (4) Nail clippings (5) Loose hair from anal region & buttocks
(6) Pubic hairs (cut) sample (7) Blood & Urine to look for sedatives/hypnotics (7) Clothes.
(8) Swabs from suspected stains on the body parts.Others if any : …………………………………………
If not preserved, reasons :…………………………………………………………………………………….
OPINION
 Findings of examination are consistent with / not inconsistent with / not consistent with the
history of alleged unnatural sexual offence.
 There is evidence / no evidence of recent / past anal penetration.
 The injuries on the body could be / could not be suggestive of resistance by the victim.
 There is evidence / no evidence of recent anal / buccal coitus. (Based on laboratory results)

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

26
 TRIPLICATE
Ref. ML / No./ VUSO :……………………….. Date :………………………………
REPORT OF EXAMINATION OF A VICTIM OF UNNATURAL SEXUAL OFFENCE
Name :……………………………………..………………………………Age :…………years. Sex : M / F
Address :………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
Requisition (if any) from ; …………….……………………………………………………………………….
vide Crime No. …………… of …………………………….……………… Police station dated ……………
and accompanied by (Name & Address.) …………….…...……………………...……………………………
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
Date, time & place of examination…………..………………………………………………………………..
Identification marks : …………………………………………..……………………………………………..
……………………………...………………………………………………………………………………….
Educational status :……………………………. Occupation …….…………………………………
History related to the incident (as stated by the subject / …………………………………………………) :
………………………………………………… ………………………………………………………………
…………………………………………………………………………………………………………………
Whether changed clothing since the incident: Yes/No/NA. Whether bathed since the incident: Yes/No/NA
Whether washed mouth / had any food or drinks / urinated / defecated since the incident: Yes/No/NA.
Whether having pain on walking/urination/defecation: Yes/No/NA. Any history of vomiting : Yes/No/NA.
Any history of bleeding from anus : Yes/No/NA. Loss of consciousness during / after the incident : Yes/No.
Physical examination
a) General : 1) Height………cm. 2) Weight…….kg. 3) Build : Good/Moderate/Poor. 4) Gait: Painful / Not
4) Mental disposition : Excited / Calm / Depressed. 5) Clothes : Intact / Disordered / Torn/NA.
b) Local : (1) Lips and oral cavity:……………. ……………………………………………………………
(2) Anus : Anal mucosa : Smooth / Thickened. Tears : Present / Absent. If present, Recent / old.
Depression of anus : Present / Not present. Hemorrhoids : Present / Not present.
Stains of blood / Semen / Lubricants : Present / Absent. Anal sphincter : Patulous / Non patulous
Anal sphincter admits one / more finger, with / without pain. Sphincter tone : Retained / Lost
Evidence of STD : Present / Not present. On bimanual lateral traction, anal orifice closes / opens.
Findings of rectal examination with speculum :…………..……………………………………………..
(3) Penis & scrotum :……………………...………………………………………………………………...
(4) Inner thigh regions & pereneum : ……………………..……….……..…………………………………
c) Injuries on the body (if any) : ……………………………………………………………….………………
……………………………………………………………………………………………………………….
………………………………………………………………………………………………………………
d) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
Material objects preserved : (1) Buccal smears and swabs (2)Anal swabs and smears
(3) Swab from skin of thighs. (4) Nail clippings (5) Loose hair from anal region & buttocks
(6) Pubic hairs (cut) sample (7) Blood & Urine to look for sedatives/hypnotics (7) Clothes.
(8) Swabs from suspected stains on the body parts.Others if any : …………………………………………
If not preserved, reasons :…………………………………………………………………………………….
OPINION
 Findings of examination are consistent with / not inconsistent with / not consistent with the
history of alleged unnatural sexual offence.
 There is evidence / no evidence of recent / past anal penetration.
 The injuries on the body could be / could not be suggestive of resistance by the victim.
 There is evidence / no evidence of recent anal / buccal coitus. (Based on laboratory results)

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

27
 ORIGINAL
Ref. ML. No./SRD : ………………….. Date : ………………….…
REPORT OF EXAMINATION FOR EVIDENCE OF RECENT DELIVERY
Requisition received from the …………………………………………………………………………. for the
examination of a female, named………...………………..…………………………………aged………years,
to look for signs of recent delivery, vide Crime No. ……………… of ………………………………………
Police station dated …………………….. and accompanied by WHC/WPC No. ……………………………

Name & Address of the subject : ……………………………………………………………………………

………………………………………………………………..………………………………………………
………………………………………………………………………………………………………………..
Age……….years. Marital status : Married / Unmarried. Occupation :…………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
…………..…………………………………………………………………………………………………….
Date, time & place of examination…………..………………………………………………………………..
Identification marks : (1) ……………………..………………..……………………………………………..
(2)…………………………...………………………………………………………………………………….
History related to gestation (as stated by the subject) : Menarche :…………………………………………
Date of last Menstrual period :……………… ………………….… Antenatal checkup : Taken / Not taken
Any other details :……………………...………………………………………………………………………
…………………………………………………………………………………………………………………
Physical examination
a) General : (1) Height…………cm. (2) Weight……….kg. (3) Build : Good / Moderate / Poor.
(4) Conjunctival pallor : Present / Not present.(5) Breasts : Engorged / Tender / Visibly full / Patulous.
(6) Areola of nipple : Dark and prominent with Montgomery’s tubercles / pale and non-prominent
(7) Nipple : Colostrum or milk could be expressed / Could not be expressed.
(8) Abdomen : Pendulous with wrinkled skin / Non-pendulous with smooth skin.
(9) Striae gravidarum : Present and reddish in color / Present as healed scars / Absent.
b) Uterus : Palpable per abdomen / Not palpable per abdomen. If palpable per abdomen, details regarding
size, tenderness etc ………………………………………………………………………………………….
……………………………………………………………………………………………………………….
c) Vagina : (1) Labia : Swollen / Not swollen (2) Labial tenderness : Present / Absent
(3) Injuries to labia : Present / Absent . If present, describe ……………………………………………….
………………………………………………………………………………………………………….
(4) Vagina : Capacious and relaxed / non-capacious with normal tone. (5) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
d) Cervix : (1) Cervical lips : Soft and swollen / Firm. (2) Cervical mucus plug : Present / Absent
(3) External Os : Closed / Open / Admits one finger / Admits two fingers. (4) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
(5) Lochia discharge at Os : Present / Not present. If present : Lochia rubra / Lochia serosa / Lochis alba
e) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
f) Laboratory examinations : Urine for pregnancy test: Positive / Negative
USG Abdomen (Optional) :………………………………………………………………………………..
Any other : ……………………………………………………………………………………………………
OPINION
 There is evidence / no evidence suggestive of a recent vaginal delivery / abortion.
 Approximate period since the date of delivery could be ……………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
28
 DUPLICATE
Ref. ML. No./SRD : ………………….. Date : ………………….…
REPORT OF EXAMINATION FOR EVIDENCE OF RECENT DELIVERY
Requisition received from the …………………………………………………………………………. for the
examination of a female, named………...………………..…………………………………aged………years,
to look for signs of recent delivery, vide Crime No. ……………… of ………………………………………
Police station dated …………………….. and accompanied by WHC/WPC No. ……………………………

Name & Address of the subject : ……………………………………………………………………………

………………………………………………………………..………………………………………………
………………………………………………………………………………………………………………..
Age……….years. Marital status : Married / Unmarried. Occupation :…………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
…………..…………………………………………………………………………………………………….
Date, time & place of examination…………..………………………………………………………………..
Identification marks : (1) ……………………..………………..……………………………………………..
(2)…………………………...………………………………………………………………………………….
History related to gestation (as stated by the subject) : Menarche :…………………………………………
Date of last Menstrual period :……………… ………………….… Antenatal checkup : Taken / Not taken
Any other details :……………………...………………………………………………………………………
…………………………………………………………………………………………………………………
Physical examination
a) General : (1) Height…………cm. (2) Weight……….kg. (3) Build : Good / Moderate / Poor.
(4) Conjunctival pallor : Present / Not present.(5) Breasts : Engorged / Tender / Visibly full / Patulous.
(6) Areola of nipple : Dark and prominent with Montgomery’s tubercles / pale and non-prominent
(7) Nipple : Colostrum or milk could be expressed / Could not be expressed.
(8) Abdomen : Pendulous with wrinkled skin / Non-pendulous with smooth skin.
(9) Striae gravidarum : Present and reddish in color / Present as healed scars / Absent.
b) Uterus : Palpable per abdomen / Not palpable per abdomen. If palpable per abdomen, details regarding
size, tenderness etc ………………………………………………………………………………………….
……………………………………………………………………………………………………………….
c) Vagina : (1) Labia : Swollen / Not swollen (2) Labial tenderness : Present / Absent
(3) Injuries to labia : Present / Absent . If present, describe ……………………………………………….
………………………………………………………………………………………………………….
(4) Vagina : Capacious and relaxed / non-capacious with normal tone. (5) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
d) Cervix : (1) Cervical lips : Soft and swollen / Firm. (2) Cervical mucus plug : Present / Absent
(3) External Os : Closed / Open / Admits one finger / Admits two fingers. (4) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
(5) Lochia discharge at Os : Present / Not present. If present : Lochia rubra / Lochia serosa / Lochis alba
e) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
f) Laboratory examinations : Urine for pregnancy test: Positive / Negative
USG Abdomen (Optional) :………………………………………………………………………………..
Any other : ……………………………………………………………………………………………………
OPINION
 There is evidence / no evidence suggestive of a recent vaginal delivery / abortion.
 Approximate period since the date of delivery could be ……………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
29
 TRIPLICATE
Ref. ML. No./SRD : ………………….. Date : ………………….…
REPORT OF EXAMINATION FOR EVIDENCE OF RECENT DELIVERY
Requisition received from the …………………………………………………………………………. for the
examination of a female, named………...………………..…………………………………aged………years,
to look for signs of recent delivery, vide Crime No. ……………… of ………………………………………
Police station dated …………………….. and accompanied by WHC/WPC No. ……………………………

Name & Address of the subject : ……………………………………………………………………………

………………………………………………………………..………………………………………………
………………………………………………………………………………………………………………..
Age……….years. Marital status : Married / Unmarried. Occupation :…………………………………….
Consent : ……………………………………………………………………………………………………..
…………………………………………………………………………………………………………………
…………..…………………………………………………………………………………………………….
Date, time & place of examination…………..………………………………………………………………..
Identification marks : (1) ……………………..………………..……………………………………………..
(2)…………………………...………………………………………………………………………………….
History related to gestation (as stated by the subject) : Menarche :…………………………………………
Date of last Menstrual period :……………… ………………….… Antenatal checkup : Taken / Not taken
Any other details :……………………...………………………………………………………………………
…………………………………………………………………………………………………………………
Physical examination
a) General : (1) Height…………cm. (2) Weight……….kg. (3) Build : Good / Moderate / Poor.
(4) Conjunctival pallor : Present / Not present.(5) Breasts : Engorged / Tender / Visibly full / Patulous.
(6) Areola of nipple : Dark and prominent with Montgomery’s tubercles / pale and non-prominent
(7) Nipple : Colostrum or milk could be expressed / Could not be expressed.
(8) Abdomen : Pendulous with wrinkled skin / Non-pendulous with smooth skin.
(9) Striae gravidarum : Present and reddish in color / Present as healed scars / Absent.
b) Uterus : Palpable per abdomen / Not palpable per abdomen. If palpable per abdomen, details regarding
size, tenderness etc ………………………………………………………………………………………….
……………………………………………………………………………………………………………….
c) Vagina : (1) Labia : Swollen / Not swollen (2) Labial tenderness : Present / Absent
(3) Injuries to labia : Present / Absent . If present, describe ……………………………………………….
………………………………………………………………………………………………………….
(4) Vagina : Capacious and relaxed / non-capacious with normal tone. (5) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
d) Cervix : (1) Cervical lips : Soft and swollen / Firm. (2) Cervical mucus plug : Present / Absent
(3) External Os : Closed / Open / Admits one finger / Admits two fingers. (4) Injuries : Present / Absent.
If present, describe ………………………………………………………………………………………..
(5) Lochia discharge at Os : Present / Not present. If present : Lochia rubra / Lochia serosa / Lochis alba
e) Systemic examination findings : ……………………………………………………………………………
……………………………………………………………………………………………………...
f) Laboratory examinations : Urine for pregnancy test: Positive / Negative
USG Abdomen (Optional) :………………………………………………………………………………..
Any other : ……………………………………………………………………………………………………
OPINION
 There is evidence / no evidence suggestive of a recent vaginal delivery / abortion.
 Approximate period since the date of delivery could be ……………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
30
Ref.ML. No./ VAD……………………..Date…………………..…. ORIGINAL
Report of examination of a victim alleged to have been drugged
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of ………...………………..……………………………..……
aged……….years, alleged to have been drugged and accompanied by HC / PC No. …………………….…

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………
Date & time of examination. : …………………………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) Date & time of the alleged incident : ……………………………………………..……..……………..
(b) Regarding mode of adminitration :…..……………………………….…………………………………
(c) Loss of consciousness : Yes / No / Can’t remember. If Yes, period of unconsciousness:……………..
(d) Whether able to remember what has happened from the point of administration to recovery : Yes / No.
(e) If Yes, was he/she able to respond to what was happening during that period : Yes / No.
(f) Any sequele that he/she is able to make out :……………………………………………………
……………………………………………………………………………………………………
General Examination:
1. Clothing : In proper order/Disordered. 2. Level of consciousness:Conscious/Semiconscious/Unconscious
3. Alertness: Alert/Drowsy/Stuperous. 3. General disposition: Calm / Anxious/ Depressed.
4. Speech : Normal / Thick and slurred / incoherent. 5. Memory (Recent/Remote) : Normal / impaired.
5. Orientation of time, place & person : Normal / impaired. 6. Reaction time : Normal / Delayed.
Physical Examination :
Height :…………..cm. Weight :…………kg. Build and nourishment : Good / Moderate / Poor.
Conjunctiva : Normal / Congested. Pupils : Pinpoint / Constricted / Normal / Dilated / Sluggishly reacting.
Nostrils and nasal mucosa :………………………………………………………………………………….
Lips, oral cavity and circum-oral regions :………………………………………………………………….
Marks of injection on the skin :……………………………………………………………………….……..
Muscular co-ordination : Normal / Impaired. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive/Negative. Finger nose test : Positive/Negative. Gait : Normal/Unsteady.
Systemic examination findings : Pulse : ………./min. B.P. : ………………………….mm of Hg.
Injuries on the body :………………………………………………………………………………………..
………………………………………………………………………………………………………………
Any other findings :…………………………………………………………………………………………
………………………………………………………………………………………………………………
Laboratory examination :
Nasal swabs : Preserved / Not applicable. Stomach Aspirate : Preserved / Not applicable.
Vomitus : Preserved /Not applicable.Blood : Preserved / Not applicable. Urine : Preserved : Not applicable.
Opinion :
1) Reserved pending results of laboratory examinations.
2) Findings of physical and laboratory examinations are consistent with / not inconsistent with /
not consistent with the alleged history of having been drugged.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

31
Ref.ML. No./ VAD……………………..Date…………………..…. DUPLICATE
Report of examination of a victim alleged to have been drugged
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of ………...………………..……………………………..……
aged……….years, alleged to have been drugged and accompanied by HC / PC No. …………………….…

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………
Date & time of examination. : …………………………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) Date & time of the alleged incident : ……………………………………………..……..……………..
(b) Regarding mode of adminitration :…..……………………………….…………………………………
(c) Loss of consciousness : Yes / No / Can’t remember. If Yes, period of unconsciousness:……………..
(d) Whether able to remember what has happened from the point of administration to recovery : Yes / No.
(g) If Yes, was he/she able to respond to what was happening during that period : Yes / No.
(h) Any sequele that he/she is able to make out :……………………………………………………
……………………………………………………………………………………………………
General Examination:
1. Clothing : In proper order/Disordered. 2. Level of consciousness:Conscious/Semiconscious/Unconscious
3. Alertness: Alert/Drowsy/Stuperous. 3. General disposition: Calm / Anxious/ Depressed.
4. Speech : Normal / Thick and slurred / incoherent. 5. Memory (Recent/Remote) : Normal / impaired.
5. Orientation of time, place & person : Normal / impaired. 6. Reaction time : Normal / Delayed.
Physical Examination :
Height :…………..cm. Weight :…………kg. Build and nourishment : Good / Moderate / Poor.
Conjunctiva : Normal / Congested. Pupils : Pinpoint / Constricted / Normal / Dilated / Sluggishly reacting.
Nostrils and nasal mucosa :………………………………………………………………………………….
Lips, oral cavity and circum-oral regions :………………………………………………………………….
Marks of injection on the skin :……………………………………………………………………….……..
Muscular co-ordination : Normal / Impaired. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive/Negative. Finger nose test : Positive/Negative. Gait : Normal/Unsteady.
Systemic examination findings : Pulse : ………./min. B.P. : ………………………….mm of Hg.
Injuries on the body :………………………………………………………………………………………..
………………………………………………………………………………………………………………
Any other findings :…………………………………………………………………………………………
………………………………………………………………………………………………………………
Laboratory examination :
Nasal swabs : Preserved / Not applicable. Stomach Aspirate : Preserved / Not applicable.
Vomitus : Preserved /Not applicable.Blood : Preserved / Not applicable. Urine : Preserved : Not applicable.
Opinion :
1) Reserved pending results of laboratory examinations.
2) Findings of physical and laboratory examinations are consistent with / not inconsistent with /
not consistent with the alleged history of having been drugged.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

32
Ref.ML. No./ VAD……………………..Date…………………..…. TRIPLICATE
Report of examination of a victim alleged to have been drugged
Requisition received from the ……….……………………….………………………………………
of …………………………………………………….. police station, dated ………………………
for the examination and certification of ………...………………..……………………………..……
aged……….years, alleged to have been drugged and accompanied by HC / PC No. …………………….…

Name : …………………………………………………………… Age : ……years. Sex : Male / Female.

Address : ………………………………………………………………..……………………………………
……………………………………………………………………………..…………………………………
Consent : ………………………………………………………………..……………………………………
…………………………………………………………………………..……………………………
Date & time of examination. : …………………………………………………………………………
Identification marks :
(1)……………………………………………………………………………………..……………………………….
(2) …………………………………………………………………………………………………………..………….
History :
(a) Date & time of the alleged incident : ……………………………………………..……..……………..
(b) Regarding mode of adminitration :…..……………………………….…………………………………
(c) Loss of consciousness : Yes / No / Can’t remember. If Yes, period of unconsciousness:……………..
(d) Whether able to remember what has happened from the point of administration to recovery : Yes / No.
(i) If Yes, was he/she able to respond to what was happening during that period : Yes / No.
(j) Any sequele that he/she is able to make out :……………………………………………………
……………………………………………………………………………………………………
General Examination:
1. Clothing : In proper order/Disordered. 2. Level of consciousness:Conscious/Semiconscious/Unconscious
3. Alertness: Alert/Drowsy/Stuperous. 3. General disposition: Calm / Anxious/ Depressed.
4. Speech : Normal / Thick and slurred / incoherent. 5. Memory (Recent/Remote) : Normal / impaired.
5. Orientation of time, place & person : Normal / impaired. 6. Reaction time : Normal / Delayed.
Physical Examination :
Height :…………..cm. Weight :…………kg. Build and nourishment : Good / Moderate / Poor.
Conjunctiva : Normal / Congested. Pupils : Pinpoint / Constricted / Normal / Dilated / Sluggishly reacting.
Nostrils and nasal mucosa :………………………………………………………………………………….
Lips, oral cavity and circum-oral regions :………………………………………………………………….
Marks of injection on the skin :……………………………………………………………………….……..
Muscular co-ordination : Normal / Impaired. Reflexes : Normal / Exaggerated / Sluggish.
Romberg’s sign : Positive/Negative. Finger nose test : Positive/Negative. Gait : Normal/Unsteady.
Systemic examination findings : Pulse : ………./min. B.P. : ………………………….mm of Hg.
Injuries on the body :………………………………………………………………………………………..
………………………………………………………………………………………………………………
Any other findings :…………………………………………………………………………………………
………………………………………………………………………………………………………………
Laboratory examination :
Nasal swabs : Preserved / Not applicable. Stomach Aspirate : Preserved / Not applicable.
Vomitus : Preserved /Not applicable.Blood : Preserved / Not applicable. Urine : Preserved : Not applicable.
Opinion :
1) Reserved pending results of laboratory examinations.
2) Findings of physical and laboratory examinations are consistent with / not inconsistent with /
not consistent with the alleged history of having been drugged.

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

33
 ORIGINAL
Ref.ML. No./PES:…………………….Date:………...………….
Certificate of Examination by a Medical Officer
As per requisition from…………………………………..……..……………………………….…………
dated.…………………,physical examination of ……………..……..……………………………………. S/o
………………..………………………………….(address) ………............……………………..…………
……………………………………………………………………………………..………………...………..,
involved in crime number……………….of ………………………….………….………… police station
was done at…………am/pm on……………………… at ………………………………………..……….
Consent : ………..…………………………………………………………………………………………..
……………………………………………………………………………………………………………….…
Identification marks :
(1)………………………………………………………………………………………………………………
(2)………………………………………………………………………………………………………………
History ( Related to illness / injury if any ) : …………………………………………………………………………
……………………………………………………………………………………………………………………………..
Findings of physical examination :
A. General : Height : …....cm. Weight : …….kg. Build & nourishment : Poor/Moderate/Obese.
Pallor : Present/Absent. Physical deformity if any :………..…………..……………………………….
Others if any :…………………………………………………..…………….……………………………
B. Systemic Examination : Pulse :………/min. Blood Pressure :……………..mm of Hg.
CVS, NS, RS & GIS :………………………………………………………………………………………
………………………………………………………………………..…………………………………….
C. Injuries (If any) :………………………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………………………………………….....
..........................................................................................................................................................
D. Investigations if any :…………………………………………………………………………………….
Opinion :
There is no evidence of any clinically identifiable illness.
There are no injuries on the person / Injuries on the person could be caused as alleged.**
Suggestions if any :……………………………………………………………………………………………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )
34
 DUPLICATE
Ref.ML. No./PES:…………………….Date:………...………….
Certificate of Examination by a Medical Officer
As per requisition from…………………………………..……..……………………………….…………
dated.…………………,physical examination of ……………..……..……………………………………. S/o
………………..………………………………….(address) ………............……………………..…………
……………………………………………………………………………………..………………...………..,
involved in crime number……………….of ………………………….………….………… police station
was done at…………am/pm on……………………… at ………………………………………..……….
Consent : ………..…………………………………………………………………………………………..
……………………………………………………………………………………………………………….…
Identification marks :
(1)………………………………………………………………………………………………………………
(2)………………………………………………………………………………………………………………
History ( Related to illness / injury if any ) : …………………………………………………………………………
……………………………………………………………………………………………………………………………..
Findings of physical examination :
A. General : Height : …....cm. Weight : …….kg. Build & nourishment : Poor/Moderate/Obese.
Pallor : Present/Absent. Physical deformity if any :………..…………..……………………………….
Others if any :…………………………………………………..…………….……………………………
B. Systemic Examination : Pulse :………/min. Blood Pressure :……………..mm of Hg.
CVS, NS, RS & GIS :………………………………………………………………………………………
………………………………………………………………………..…………………………………….
C. Injuries (If any) :………………………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………………………………………….....
..........................................................................................................................................................
D. Investigations if any :…………………………………………………………………………………….
Opinion :
There is no evidence of any clinically identifiable illness.
There are no injuries on the person / Injuries on the person could be caused as alleged.**
Suggestions if any :……………………………………………………………………………………………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

35
 TRIPLICATE
Ref.ML. No./PES:…………………….Date:………...………….
Certificate of Examination by a Medical Officer
As per requisition from…………………………………..……..……………………………….…………
dated.…………………,physical examination of ……………..……..……………………………………. S/o
………………..………………………………….(address) ………............……………………..…………
……………………………………………………………………………………..………………...………..,
involved in crime number……………….of ………………………….………….………… police station
was done at…………am/pm on……………………… at ………………………………………..……….
Consent : ………..…………………………………………………………………………………………..
……………………………………………………………………………………………………………….…
Identification marks :
(1)………………………………………………………………………………………………………………
(2)………………………………………………………………………………………………………………
History ( Related to illness / injury if any ) : …………………………………………………………………………
……………………………………………………………………………………………………………………………..
Findings of physical examination :
A. General : Height : …....cm. Weight : …….kg. Build & nourishment : Poor/Moderate/Obese.
Pallor : Present/Absent. Physical deformity if any :………..…………..……………………………….
Others if any :…………………………………………………..…………….……………………………
B. Systemic Examination : Pulse :………/min. Blood Pressure :……………..mm of Hg.
CVS, NS, RS & GIS :………………………………………………………………………………………
………………………………………………………………………..…………………………………….
C. Injuries (If any) :………………………………………………………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………………………………………….....
..........................................................................................................................................................
D. Investigations if any :…………………………………………………………………………………….
Opinion :
There is no evidence of any clinically identifiable illness.
There are no injuries on the person / Injuries on the person could be caused as alleged.**
Suggestions if any :……………………………………………………………………………………………

Date : …………………….. Signature : …………………………….

Place : …………………….. Name : ……………………………
Name of Institution. : ……………………………. Designation : ……………...………………….
(strike off which is not applicable)
Received the certificate : ……………………………………….. ( Signature & P.C.No. )

36
 ORIGINAL
Ref.ML. No./PES:……………………. Date:………...………….
Certificate of Examination by a Specialist Medical Officer/ Team of Specialist Medical Officers

As per requisition from……………...…………………………………………………………….

dated……………………...physical examination of………………………………………………
S/o…………………………………..(address)…………..………….……………………………..
……………………………………………………………………………………………………….,
involved in crime number……………….of ………………...………………….…………………
police station was done at………………..on………………………….
Consent :……………………………………………………………………………………………
………………………………………………………………………………………………………..
Identification marks:
(1)…………………………………………………….……………………………………………....
(2)………………………………….…………………………………………………………………
History:………………………………………………………………………………………………
……………………………………………………………………………………………………….
Findings of physical examination :………………………………………………………...……….
………………………………………………………………………………………………...………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Results of Investigations if any:…………………………………….………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion :…………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Place :……………………
Date :…………………… Signature :
Name :……………………….……………
Designation :…………………………………….
Signature, name & designation of other members of the team if present
1) ……………………………………………………………………………………………….
2) ………………………………………………………………………………………………..
Name of Institution : ……………………….………...………………………………………………
Issued to :………………………………...………………………………………………………….

37
 DUPLICATE
Ref.ML. No./PES:……………………. Date:………...………….
Certificate of Examination by a Specialist Medical Officer/ Team of Specialist Medical Officers

As per requisition from……………...…………………………………………………………….

dated……………………...physical examination of………………………………………………
S/o…………………………………..(address)…………..………….……………………………..
……………………………………………………………………………………………………….,
involved in crime number……………….of ………………...………………….…………………
police station was done at………………..on………………………….
Consent :……………………………………………………………………………………………
………………………………………………………………………………………………………..
Identification marks:
(1)…………………………………………………….……………………………………………....
(2)………………………………….…………………………………………………………………
History:………………………………………………………………………………………………
……………………………………………………………………………………………………….
Findings of physical examination :………………………………………………………...……….
………………………………………………………………………………………………...………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Results of Investigations if any:…………………………………….………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion :…………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Place :……………………
Date :…………………… Signature :
Name :……………………….……………
Designation :…………………………………….
Signature, name & designation of other members of the team if present
1) ……………………………………………………………………………………………….
2) ………………………………………………………………………………………………..
Name of Institution : ……………………….………...………………………………………………
Issued to :………………………………...………………………………………………………….

38
 TRIPLICATE
Ref.ML. No./PES:……………………. Date:………...………….
Certificate of Examination by a Specialist Medical Officer/ Team of Specialist Medical Officers

As per requisition from……………...…………………………………………………………….

dated……………………...physical examination of………………………………………………
S/o…………………………………..(address)…………..………….……………………………..
……………………………………………………………………………………………………….,
involved in crime number……………….of ………………...………………….…………………
police station was done at………………..on………………………….
Consent :……………………………………………………………………………………………
………………………………………………………………………………………………………..
Identification marks:
(1)…………………………………………………….……………………………………………....
(2)………………………………….…………………………………………………………………
History:………………………………………………………………………………………………
……………………………………………………………………………………………………….
Findings of physical examination :………………………………………………………...……….
………………………………………………………………………………………………...………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Results of Investigations if any:…………………………………….………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion :…………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Place :……………………
Date :…………………… Signature :
Name :……………………….……………
Designation :…………………………………….
Signature, name & designation of other members of the team if present
1) ……………………………………………………………………………………………….
2) ………………………………………………………………………………………………..
Name of Institution : ……………………….………...………………………………………………
Issued to :………………………………...………………………………………………………….

39
Ref.ML. No/MOC.:…………………….Date…………….…..……… ORIGINAL

Certificate of collection of material objects from the body of a person for

chemical examination, DNA profiling, examination at FSL, etc
Requisition received from ……………………………………………………………………….
Dated……………………………..for the collection of ……………………………………………
………………………………………………………………………………………………………..
from the body of a male / female, …………………………………………………………………..
aged …………years, involved in Crime no………………………….of…………………………….
police station at ………………………..a.m / pm., on ……………………….. The subject was
accompanied by ……………………………………………………………………………………...
Name & address of the subject :……………………………………………………………………..
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
Consent :……………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Identification marks :…………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………..
Material objects collected :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Material objects which were requested to be collected, but could not be collected if any …………
………………………………………………………………………………………………………..

Reasons for not collecting :…………………………………………………………………………..

………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Handed over the sealed packets containing the material objects requested

Signature :
Date :…………………… Name :………………………………………………………
Place :…………………… Designation :………………………………………………………
Name of Institution : ………………………...………………………………………………..…………………………
Issued to :………………………………………………………………………….…………………………………….
(** Strike off whichever is not applicable)

Received the sealed packet containing the material objects :

(Signature, name and designation)

40
Ref.ML. No/MOC.:…………………….Date…………….…..……… DUPLICATE

Certificate of collection of material objects from the body of a person for

chemical examination, DNA profiling, examination at FSL, etc
Requisition received from ……………………………………………………………………….
Dated……………………………..for the collection of ……………………………………………
………………………………………………………………………………………………………..
from the body of a male / female, …………………………………………………………………..
aged …………years, involved in Crime no………………………….of…………………………….
police station at ………………………..a.m / pm., on ……………………….. The subject was
accompanied by ……………………………………………………………………………………...
Name & address of the subject :……………………………………………………………………..
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
Consent :……………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Identification marks :…………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………..
Material objects collected :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Material objects which were requested to be collected, but could not be collected if any …………
………………………………………………………………………………………………………..

Reasons for not collecting :…………………………………………………………………………..

………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Handed over the sealed packets containing the material objects requested

Signature :
Date :…………………… Name :………………………………………………………
Place :…………………… Designation :………………………………………………………
Name of Institution : ………………………...………………………………………………..…………………………
Issued to :………………………………………………………………………….…………………………………….
(** Strike off whichever is not applicable)

Received the sealed packet containing the material objects :

(Signature, name and designation)

41
Ref.ML. No/MOC.:…………………….Date…………….…..……… TRIPLICATE

Certificate of collection of material objects from the body of a person for

chemical examination, DNA profiling, examination at FSL, etc
Requisition received from ……………………………………………………………………….
Dated……………………………..for the collection of ……………………………………………
………………………………………………………………………………………………………..
from the body of a male / female, …………………………………………………………………..
aged …………years, involved in Crime no………………………….of…………………………….
police station at ………………………..a.m / pm., on ……………………….. The subject was
accompanied by ……………………………………………………………………………………...
Name & address of the subject :……………………………………………………………………..
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
Consent :……………………………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Identification marks :…………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………..
Material objects collected :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Material objects which were requested to be collected, but could not be collected if any …………
………………………………………………………………………………………………………..

Reasons for not collecting :…………………………………………………………………………..

………………………………………………………………………………………………………
……………………………………………………………………………………………………….

Handed over the sealed packets containing the material objects requested

Signature :
Date :…………………… Name :………………………………………………………
Place :…………………… Designation :………………………………………………………
Name of Institution : ………………………...………………………………………………..…………………………
Issued to :………………………………………………………………………….…………………………………….
(** Strike off whichever is not applicable)

Received the sealed packet containing the material objects :

(Signature, name and designation)

42
 ORIGINAL
Label to be attached to the material objects preserved during a medico-legal examination

1. Ref. ML. No./……….…………………………………… Date:…………………………………..

Name of the Subject:…………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
2. Ref. ML. No./……….………………………………….. Date:…………………………………..
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
3. Ref. ML. No./………….……………………………….. Date:………………………………
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
4. Ref. ML. No./…………..……………………………….. Date:………………………………
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
5. Ref. ML. No./…………………………………………….. Date:………………………………
Name of the Subject:…………………………..……………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
6. Ref. ML. No./…………………………………………….. Date:………………………………
Name of the Subject:……………………….………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
------------------------------------- ------------------------ ---------------------------------- ---------------------

43
 DUPLICATE
Label to be attached to the material objects preserved during a medico-legal examination

1. Ref. ML. No./……….…………………………………… Date:…………………………………..

Name of the Subject:…………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
2. Ref. ML. No./……….………………………………….. Date:…………………………………..
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
3. Ref. ML. No./………….……………………………….. Date:………………………………
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
4. Ref. ML. No./…………..……………………………….. Date:………………………………
Name of the Subject:………………………………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
5. Ref. ML. No./…………………………………………….. Date:………………………………
Name of the Subject:…………………………..……………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
6. Ref. ML. No./…………………………………………….. Date:………………………………
Name of the Subject:……………………….………………………………………… Age……years.
Specimen :
Preservative :
Signature of the Medical Officer
------------------------------------- ------------------------ ---------------------------------- ---------------------

44
 ORIGINAL
Office of the …………………………………..
……………………… dated………………….
Report to be forwarded with material objects sent for chemical analysis
1. Ref. ML. No./……………….. : ………………………… Dated : ………………….
2.Name of the subject : …………………….………………………………………… Age : ……… years.
3. Address : ……………………………………………………………………………………………………
……………………………………………………………………………………………………………
4. Crime No. ………………….. of ……………………………………………….………..Police station.
5. Medico-legal examination conducted :……………………………………………………………………..
6. Material Objects preserved Preservative used (if any)
………………………………………………………………………………………………………..………
…………………………………………………………………………………..................................………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………………………………………..….
7. Mode of packing : Collected in glass bottles / wrapped with paper , tied and sealed.
8. Copy of labels affixed to bottles / packages : Attached.
9. Impression seal affixed to the bottles :
10. History of the case : ………………………….………………………………………………………….
11. Findings of examination : ………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
12. Examination required : …………………………………………………………………………………….
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….

Signature :
Name : ……………………………………
Designation :…………………………………

To
The Regional Chemical Examiner To Government, ………………………………………………………
Sir,
I am forwarding the above mentioned material objects through Sri. ……………………………………..
PC. No. …………….. for chemical examination and certificate. I request that three copies of your
certificate may be sent to me at an early date.
Yours faithfully,

(Office Seal) Name :…………………………..…………….

Date :……………………….. Designation : ………………………………
45
 DUPLICATE
Office of the …………………………………..
……………………… dated………………….
Report to be forwarded with material objects sent for chemical analysis
1. Ref. ML. No./……………….. : ………………………… Dated : ………………….
2.Name of the subject : …………………….………………………………………… Age : ……… years.
3. Address : ……………………………………………………………………………………………………
……………………………………………………………………………………………………………
4. Crime No. ………………….. of ……………………………………………….………..Police station.
5. Medico-legal examination conducted :……………………………………………………………………..
6. Material Objects preserved Preservative used (if any)
………………………………………………………………………………………………………..………
…………………………………………………………………………………..................................………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………………………………………………………………………………………..….
7. Mode of packing : Collected in glass bottles / wrapped with paper , tied and sealed.
8. Copy of labels affixed to bottles / packages : Attached.
9. Impression seal affixed to the bottles :
10. History of the case : ………………………….………………………………………………………….
11. Findings of examination : ………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
12. Examination required : …………………………………………………………………………………….
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….

Signature :
Name : ……………………………………
Designation :…………………………………

To
The Regional Chemical Examiner To Government, ………………………………………………………
Sir,
I am forwarding the above mentioned material objects through Sri. ……………………………………..
PC. No. …………….. for chemical examination and certificate. I request that three copies of your
certificate may be sent to me at an early date.
Yours faithfully,

(Office Seal) Name :…………………………..…………….

Date :……………………….. Designation : ………………………………
46
Label to be affixed on the sealed packet of different material objects collected from
one medico-legal examination, for dispatch to the center of analysis

Type of medico-legal examination conducted :…………………………………………………

………………………………………………………………………………………………………
Material objects : 1) ………………………………………………………………………………
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
……………………………………………………………………………………………………..…
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Ref. ML. No. /……..…………….……… Date………….…………….
Name of the Subject;…………………………………………………age:…..yrs. Sex :M/F
Crime No. ……………….of ………………………………………………………police station.
Date:………………………… Signature of M.O. :
Place:……………………….. Name & Designation :

---------------------------------------------------- ------------------------------------------------------------------

Label to be affixed on the sealed packet for Chemical Analysis of material objects

Type of medico-legal examination conducted :………………………………………………

…
………………………………………………………………………………………………………
Material objects : 1) ………………………………………………………………………………
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
……………………………………………………………………………………………………..…
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Ref. ML. No./… …………….……… Date………….…………….
Name of the Subject;…………………………………………………age:…..yrs. Sex :M/F
Crime No. ……………….of ………………………………………………………police station.
Date:………………………… Signature of M.O. :
Place:……………………….. Name & Designation :

47
 ORIGINAL
From To
…………………………………………, The S.I. of police,
………………………………………….. ……..………………………. police station.
Sir,
I am to inform you that the following material objects are preserved from the body of
…………………………………………………………… aged ……years, male / female, as part of
…………………………….……………..(type of examination conducted) on …………………
1) ……………………………………………………………………………………………………..
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
You may depute a police constable for their dispatch, within two weeks of this intimation.

Place:………….. Signature ………………………………………

Date………….. Name & Designation:……………………………… ……………..…
Name of Institution :…………………………………………………………………………………
Received the Original of Intimation Signature & P.C. No……………………………………….
---------------------------- ------------------------------------ --------------------------- ---------------------
ORIGINAL
From To
…………………………………………, The S.I. of police,
………………………………………….. ……..………………………. police station.
Sir,
I am to inform you that the following material objects are preserved from the body of
…………………………………………………………… aged ……years, male / female, as part of
…………………………….……………..(type of examination conducted) on …………………
1) ……………………………………………………………………………………………………..
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
You may depute a police constable for their despatch, within two weeks of this intimation.

Place:………….. Signature ………………………………………

Date………….. Name & Designation:……………………………… ……………..…
Name of Institution :…………………………………………………………………………………
Received the Original of Intimation Signature & P.C. No………………………………………

48
.
DUPLICATE
From To
…………………………………………, The S.I. of police,
………………………………………….. ……..………………………. police station.
Sir,
I am to inform you that the following material objects are preserved from the body of
…………………………………………………………… aged ……years, male / female, as part of
…………………………….……………..(type of examination conducted) on …………………
1) ……………………………………………………………………………………………………..
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
You may depute a police constable for their despatch, within two weeks of this intimation.

Place:………….. Signature ………………………………………

Date………….. Name & Designation:……………………………… ……………..…
Name of Institution :…………………………………………………………………………………
Received the Original of Intimation Signature & P.C. No……………………………………….
---------------------------- ------------------------------------ --------------------------- ---------------------
DUPLICATE
From To
…………………………………………, The S.I. of police,
………………………………………….. ……..………………………. police station.
Sir,
I am to inform you that the following material objects are preserved from the body of
…………………………………………………………… aged ……years, male / female, as part of
…………………………….……………..(type of examination conducted) on …………………
1) ……………………………………………………………………………………………………..
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
You may depute a police constable for their despatch, within two weeks of this intimation.

Place:………….. Signature ………………………………………

Date………….. Name & Designation:……………………………… ……………..…
Name of Institution :…………………………………………………………………………………
Received the Original of Intimation Signature & P.C. No……………………………………….
49
 ORIGINAL
Ref. ML. No./ AGE. ……………… Date : …………………
REPORT OF EXAMINATION FOR ESTIMATION OF AGE
Requisition received from the ……………………………………………………………………….
Dated………..……for the examination and certification of age of ………………………………
…………………………………………..…….… male/female, involved in Crime No. ……….. of
…………………………………..... police station and accompanied by……………………………
1. Name of the subject : ……………………………………………………………………………..
2. Address : ………………………………………………………………………………………….
…………………………………………………………………………………………………….
3. Age : ……….yrs.(…………………………………………….years) as stated by the subject.
4. Consent : …………………………………………………………………………………………
……………………………………………………………………………………………………
5. Date and time of examination : ………………………………………………………………….
6. Identification marks (1)……………………………………………………………………………
(2)………………………………….………………………………………………………………
7. Physical examination :
Height………….cm. Weight………kg. General build : Poor / Moderate / Good.
Voice : Masculine / Feminine. Adam’s apple : Prominent / Not prominent.
Hair : Moustache : …………………………………. Pubic :……….…………………………
Axillary : ……………………………………. Chest : …….…………………………...
Breasts : ………………………………………………………………………….……………...
External genitalia : …………………………………………………………………………..…..
Menarchy / Ejaculation :…………………………………………………………………………
Date of last menstrual period (for females ) : …………………………………………………..
8. Dental examination :
Total number of teeth : ………….… Temporary :………….. Permanent : ….….……….
Details :………………………………………………………………………………………..
…………………………………………………………………………………………………
9. Radiological examination :
Regions Findings
a) Shoulder : ……………………………………………………………………………………
……………………………………………………………………………………………….
b) Elbow : ……………………………………………………………………………………
……………………………………………………………………………………………….
………………………………………………………………………………………………..
c) Wrist : ……………………………………………………………………………………
………………………………………………………………………………………………..
d) Pelvis :…………………………………………………………………………………….
………………………………………………………………………………………………..
………………………………………………………………………………………………..
f) Skull & jaw :……………………………………………………………………………………

Opinion : Based on physical, dental and radiological findings, I am of the opinion that the subject
is aged above …(…..………………..) years and below ….(……..…………………) years of age.

Signature :
Date :……………………… Name :……………………………………
Place :……………………… Designation :………………………..………….
Name of institution ……………………………………………………………………………………………………….
Forwarded to : ………………………………………………………………………………………………….…………
50
 DUPLICATE
Ref. ML. No./ AGE. ……………… Date : …………………
REPORT OF EXAMINATION FOR ESTIMATION OF AGE
Requisition received from the ……………………………………………………………………….
Dated………..……for the examination and certification of age of ………………………………
…………………………………………..…….… male/female, involved in Crime No. ……….. of
…………………………………..... police station and accompanied by……………………………
1. Name of the subject : ……………………………………………………………………………..
2. Address : ………………………………………………………………………………………….
…………………………………………………………………………………………………….
3. Age : ……….yrs.(…………………………………………….years) as stated by the subject.
4. Consent : …………………………………………………………………………………………
……………………………………………………………………………………………………
5. Date and time of examination : ………………………………………………………………….
6. Identification marks (1)……………………………………………………………………………
(2)………………………………….………………………………………………………………
7. Physical examination :
Height………….cm. Weight………kg. General build : Poor / Moderate / Good.
Voice : Masculine / Feminine. Adam’s apple : Prominent / Not prominent.
Hair : Moustache : …………………………………. Pubic :……….…………………………
Axillary : ……………………………………. Chest : …….…………………………...
Breasts : ………………………………………………………………………….……………...
External genitalia : …………………………………………………………………………..…..
Menarchy / Ejaculation :…………………………………………………………………………
Date of last menstrual period (for females ) : …………………………………………………..
8. Dental examination :
Total number of teeth : ………….… Temporary :………….. Permanent : ….….……….
Details :………………………………………………………………………………………..
…………………………………………………………………………………………………
9. Radiological examination :
Regions Findings
b) Shoulder : ……………………………………………………………………………………
……………………………………………………………………………………………….
b) Elbow : ……………………………………………………………………………………
……………………………………………………………………………………………….
………………………………………………………………………………………………..
c) Wrist : ……………………………………………………………………………………
………………………………………………………………………………………………..
d) Pelvis :…………………………………………………………………………………….
………………………………………………………………………………………………..
………………………………………………………………………………………………..
f) Skull & jaw :……………………………………………………………………………………

Opinion : Based on physical, dental and radiological findings, I am of the opinion that the subject
is aged above …(…..………………..) years and below ….(……..…………………) years of age.

Signature :
Date :……………………… Name :……………………………………
Place :……………………… Designation :………………………..………….
Name of institution ……………………………………………………………………………………………………….
Forwarded to : ………………………………………………………………………………………………….…………
51
 TRIPLICATE
Ref. ML. No./ AGE. ……………… Date : …………………
REPORT OF EXAMINATION FOR ESTIMATION OF AGE
Requisition received from the ……………………………………………………………………….
Dated………..……for the examination and certification of age of ………………………………
…………………………………………..…….… male/female, involved in Crime No. ……….. of
…………………………………..... police station and accompanied by……………………………
1. Name of the subject : ……………………………………………………………………………..
2. Address : ………………………………………………………………………………………….
…………………………………………………………………………………………………….
3. Age : ……….yrs.(…………………………………………….years) as stated by the subject.
4. Consent : …………………………………………………………………………………………
……………………………………………………………………………………………………
5. Date and time of examination : ………………………………………………………………….
6. Identification marks (1)……………………………………………………………………………
(2)………………………………….………………………………………………………………
7. Physical examination :
Height………….cm. Weight………kg. General build : Poor / Moderate / Good.
Voice : Masculine / Feminine. Adam’s apple : Prominent / Not prominent.
Hair : Moustache : …………………………………. Pubic :……….…………………………
Axillary : ……………………………………. Chest : …….…………………………...
Breasts : ………………………………………………………………………….……………...
External genitalia : …………………………………………………………………………..…..
Menarchy / Ejaculation :…………………………………………………………………………
Date of last menstrual period (for females ) : …………………………………………………..
8. Dental examination :
Total number of teeth : ………….… Temporary :………….. Permanent : ….….……….
Details :………………………………………………………………………………………..
…………………………………………………………………………………………………
9. Radiological examination :
Regions Findings
c) Shoulder : ……………………………………………………………………………………
……………………………………………………………………………………………….
b) Elbow : ……………………………………………………………………………………
……………………………………………………………………………………………….
………………………………………………………………………………………………..
c) Wrist : ……………………………………………………………………………………
………………………………………………………………………………………………..
d) Pelvis :…………………………………………………………………………………….
………………………………………………………………………………………………..
………………………………………………………………………………………………..
f) Skull & jaw :……………………………………………………………………………………

Opinion : Based on physical, dental and radiological findings, I am of the opinion that the subject
is aged above …(…..………………..) years and below ….(……..…………………) years of age.

Signature :
Date :……………………… Name :……………………………………
Place :……………………… Designation :………………………..………….
Name of institution ……………………………………………………………………………………………………….
Forwarded to : ………………………………………………………………………………………………….…………
52
 Request for Radiological examination as part of estimation of Age

Ref. ML. No./AGE :………………

From
…………………………………………..
……………………………………………
To
The Professor / Medical Officer I/C
Department of Radiology
……………………………………………
Sir / Madam,
Sub.: Estimation of age of ………………………………………………………………
Ref. : Requisition from ………………………………………………………………….
……………………………………………………..dated………………………..
I request that Radiographs of the subject may be taken as indicated below.
Sl. No. Area View
1. ……………………….………………. …………………………………………….
2. ……………………………….………. …………………………………………….
3. ………………………….……………. ……………………………………………..
4. ………………………….……………. …………………………………………….
5. …………………….…………………. …………………………………………….
6. ……………………….………………. ……………………………………………..
7. ………………………….……………. …………………………………………….
8. …………………………….…………. …………………………………………….

The subject bears the following identification marks :

1. ………………………………………………………………………………………………….
2. ………………………………………………………………………………………………….

I request you that the X-ray plates may be sent to me at an early date.
Yours faithfully
Date :……………………... Signature :
Place :………………………. Name & Designation :

53
 Mortuary Register

SL. No………………… Date:……………………… Time:………………………….

Name of the deceased:……………………………………..……Age………yrs Sex: Male/Female
Address:……………………………………………………………………………….…………….
……………………………………………………………………………………….………………
Alleged cause of death :………………………………………………………………………...…….
Deceased was brought by / from :……………………………………………………………………
………………………………………………………………………………………………………..
Dead body was kept in Mortuary / Cold room at ……………………………on…………………….
Intimation given to : Police / Corporation / Municipality / Panchayat / Relatives/ Not necessary.
Articles on the body, kept under safe custody :……………………………………………………
………………………………………………………………………………………………………..
………………………………………………………………………………………………………..
Any other remarks :…………………………………………………………………………………..
………………………………………………………………………………………………………..

Signature & Name of Signature, Name & Designation

Staff/Head Nurse I/C of Medical Officer I/C

Body handed over to: Legal heir / Police / Academic Institutions / Hospital or Local body
Authorities / ……………………at…………………………….on……………………………..for
cremation or burial by legal heirs / Inquest / Academic purpose / Disposal by hospital or local body
authorities.

Received the dead body of ………………..………………………………………………………….

aged………years, at ……..………….………...on…………….………………………alongwith the
articles recovered from the body and kept in safe custody, as enlisted above.

Signature, Name, Address/Designation of ]

the person receiving the dead body ]

Signature & Name of Signature, Name & Designation

Staff/Head Nurse I/C of Medical Officer I/C
54
 Register of Postmortem Examinations

P.M. No………………………. Date :………………………

Name of the deceased :……………………………………………………………………………..

……………………………………………Age :…………..years Sex : Male / Female / Not known.

Crime No. ……………………of…………………………………………….……….police station.

Requisition from :……………………………………………………………………………………

………………………………………………………………………………………………………..

Alleged cause of death as per inquest :……………………………………………………………….

Name & Designation of Medical Officer :…………………………………………………………...

Assisted by …………………………………………….and…………………………………………

Remarks if any :………………………………………………………………………………………

Signature of the M O : Signature of Charge H.C./P.C. :

--------------------------------------- -------------------------------------- ----------------------------------------

P.M. No………………………. Date :………………………

Name of the deceased :……………………………………………………………………………..

……………………………………………Age :…………..years Sex : Male / Female / Not known.

Crime No. ……………………of…………………………………………….……….police station.

Requisition from :……………………………………………………………………………………

………………………………………………………………………………………………………..

Alleged cause of death as per inquest :……………………………………………………………….

Name & Desidnation of Medical Officer :…………………………………………………………...

Assisted by …………………………………………….and…………………………………………

Remarks if any :………………………………………………………………………………………

Signature of the M O : Signature of Charge H.C./P.C. :

55
 Receipt for Dead body for Postmortem examination

Received the dead body of ……………………….…………………….……………………………,

male/female, stated to be aged …….…….years, involved in crime No. ……….…………….of
………………………………………………………………police station, at ………………am/pm
on ……………………… as per requisition from …………….…………………………………….
………………………………...……., through P.C. No………………for postmortem examination.

Signature :

Name : ………………….…………………………
Designation :………………………………….…….……
Name of the Institution :…………………………………..………….……
--------------------------------------------------------------------------------------------------------------------- -
Receipt for Dead body for Postmortem examination

Received the dead body of ……………………….………………….……………………………,

male/female, stated to be aged ……..….years, involved in crime No. ……………..……….of
………………………………………………...…………police station, at ………………am/pm on
…………………….… as per requisition from ………….………………………………………….
…………………………………...…., through P.C. No………………for postmortem examination.

Signature :
Name : ………………..……………………………
Designation :……………………..………………….……
Name of the Institution :…………………………………...………….……
---------------------------------------------------------------------------------------------------------------------
Receipt for Dead body for Postmortem examination

Received the dead body of ……………………….…………………….……………………………,

male/female, stated to be aged ……..….years, involved in crime No. ……………….…….of
…………………………………..………………………police station, at ………………am/pm on
……………………… as per requisition from …………………..………………………………….
………………………………...……., through P.C. No………………for postmortem examination.

Signature :
Name : ……………………………………………
Designation :……………….…...………………….……
Name of the Institution :……………………………………….……

56
P.M. No………………. Date ………….……………

POST-MORTEM DETAILED NOTES

On the body of a male / female …………………….………………………….……………………
aged about ………… years sent by …………………………………………………………….…
…………………………………………………….. with letter Crime No. …………………….
dated …………………… in charge of H.C. / P.C. No.…………………………

Body identified By :
Signature :

Name :…………………………………………………

H.C. / P.C. No. :…………………………………………………

The body was first seen at …………….………..…………. on …………….……………….

Postmortem examination was commenced at ……………...…….…… on …………………………
Post-mortem examination was conducted by : Dr…………………………………………… and
was assisted by ……………………………………… and ………………………………………….

Notes on Scene Examination :

Clothes, weapons and other articles sent with the body:

57
 Schedule of observations
A. GENERAL
Body : Entire and intact / Mutilated and in pieces Sex: Male / Female. Ht. ………cm.
Wt. …….…kg. Build : Thin / Moderate / Well. Nourishment : Poor / Moderate / Well / Obese.
Smell :…………………………………………………Facial appearance : Pale / Normal / Livid.
Eyes : Closed / Half open / Open. …………………………………………………………………..
Corneae : Clear / Hazy / Opaque…………………………………………………………………….
Pupils : Constricted / Dialated / Regular / Irregular …………………………………………………
Conjunctivae : Pale / Normal / Congested …………………………………………………………..
Nostrils :………………………………………………. ………………………………..……………
Mouth :……………………………………………………………………………………………….
Tongue : ………………………….…………….Lips : Pale / Blue /…………….…………………..
Circum-oral regions …………………………..………..Oral cavity :……………………………….
Inner aspects of lips…………………………………………………………………………………..
Ears : ……………………………………….. Urethral orifice :…………………………………….
Anus :…………………………………………………………………………………………………
Rigor mortis :…………………………………………………………………………………………
Postmortem staining :………………………………………………………………………………...
Dried salivary dribble mark :…………………………………………………………………………
Smearings on the body :………………………………………………………………………………
Postmortem ant bite marks :………………………………………………………………………….
Postmortem aquatic or other animal bite marks :……………………………………………………
……………………………………………………………………………………………………….
Postmortem burns due to exposure to sunlight :……………………………………………………..
………………………………………………………………………………………………………..
Decomposition changes :…………………………………………………………………………….
………………………………………………………………………………………………………..
Any other findings :………………………………………………………………………………….

Body was kept in cold room (If it was kept) at …………………..……. on ………………………

58
 B. INJURIES (Ante-mortem)
External :

59
60
Internal :

61
62
 C. INTERNAL EXAMINATION
I) Head and Neck :
Scalp :
Skull :
Meninges and cerebral Vessels:
Brain :

Subcutaneous tissues & muscles of neck:

Mouth and Pharynx:
Cartilages of neck :
Hyoid bone:

II) Chest :
Ribs and chest wall :
Pleural cavities:
Diaphragm:
Mediastinum and thymus :
Oesophagus:
Trachea and bronchi:
Lungs : Right :
Left :
Pericardial sac:
Heart : General :
Walls :
Valves :
Chambers :
Coronaries :
Aorta :

III) Abdomen :
Abdominal wall:
Peritoneal cavity:
Liver :
Gall bladder and Billary passages:

63
Spleen :
Kidneys : Right : Left :
Pancreas:
Adrenal glands: Right : Left :
Stomach and contents:

Intestines and mesentery:

Urinary bladder:
Genital Organs:
Spinal Column and Cord:
ADDITIONAL OBSERVATIONS

Viscera and other Material Objects for Chemical and Other Examinations :
(1) Stomach, small intestine and contents (2) Part of Liver and Kidney. (3) Blood (4) Urine
(5) Preservative for 1 & 2 (saturated saline) (6) Preservative for 3 & 4 Sodium fluoride
(7)
(8)
(9)

Post-mortem examination concluded at ..…………………………. On ……………………..……

OPINION AS TO CAUSE OF DEATH:

Station: Signature
Date : Name :
Designation :

Received the dead body after postmortem examination along with the articles mentioned in K.P.F.
No. 102 at ……………………….. on ……………………………
Signature P.C. No.
64
 ORIGINAL
P.M. No:………………… Dated,…………………….
POSTMORTEM CERTIFICATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the undersigned and the postmortem examination commenced at……………on
…………..…and concluded at ……………on the same day. The alleged cause of death
as per inquest was …………………………………………………………………………………
……………………………………………………………………………………………………..…
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
Post-mortem findings

Opinion :

Signature :
Date :…………………… Name :……………………………………
Place :…………………… Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..
65
 DUPLICATE
P.M. No:………………… Dated,…………………….
POSTMORTEM CERTIFICATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the undersigned and the postmortem examination commenced at……………on
…………..…and concluded at ……………on the same day. The alleged cause of death
as per inquest was …………………………………………………………………………………
……………………………………………………………………………………………………..…
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
Post-mortem findings

Opinion :

Signature :
Date :…………………… Name :……………………………………
Place ;…………………… Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..
66
 TRIPLICATE
P.M. No:………………… Dated,…………………….
POSTMORTEM CERTIFICATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the undersigned and the postmortem examination commenced at……………on
…………..…and concluded at ……………on the same day. The alleged cause of death
as per inquest was …………………………………………………………………………………
……………………………………………………………………………………………………..…
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
Post-mortem findings

Opinion :

Signature :
Date :…………………… Name :……………………………………
Place :…………………… Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..
67
 QUADRUPLICATE
P.M. No:………………… Dated,…………………….
POSTMORTEM CERTIFICATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the undersigned and the postmortem examination commenced at……………on
…………..…and concluded at ……………on the same day. The alleged cause of death
as per inquest was …………………………………………………………………………………
……………………………………………………………………………………………………..…
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
Post-mortem findings

Opinion :

Signature :
Date :…………………… Name :……………………………………
Place ;…………………… Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..
68
 Office of the……...……………………………………
…………………………..dated………………………..
From
…………………………………………..
……………………………………………
To (Affix the Sample Seal here)
The Professor / Medical Officer I/C
Department of Pathology
……………………………………………
Sir / Madam,
Sub.: Histo-pathological Examination of specimens preserved during the postmortem examination
Ref. : PM. No. ……………………....dated …………………………..………….
I request that the histo-pathological examination of the following specimens, preserved from the
deadbody of ………………….……………………………………………………..., Male / Female,
aged ……….years, involved in Crime No…………….of ……………………………….…………
…………………………………………….…………..police station may be conducted, as the
findings of such examination are absolutely necessary for furnishing opinion as to cause of death .
The alleged cause of death as per requisition for postmortem examination was
………………………………………………………………………………………………………..
Relevant findings of autopsy are ……………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………..
1. ……………………….………………………………………………………………………….
2. ……………………………….………. …………..…………………………………………….
3. ………………………….………………………………………………………………………..
4. ………………………….…………………………..…………………………………………….
5. …………………….……………………………………………………………………………….
6. ……………………….……………………………...……………………………………………..
I am sending the specimens in sealed packet through H.C./P.C. No……………. I request you
that the results may be made ready at an early date, so as to be collected through police.

Yours faithfully

Date :……………………... Signature :

Place :………………………. Name & Designation :

69
 ORIGINAL
LABEL TO BE ATTACHED TO MATERIAL OBJECTS SENT FOR CHEMICAL
ANALYSIS (Preserved during postmortem examination)
1. P.M. No…………………………………….. Date:…………………………………..
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Stomach with contents and first 30cm of intestine with contents.
Preservative : Saturated Saline.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
2. P.M. No…………………………………….. Date:…………………………………..
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : 500gms of liver and one half of each kidney.
Preservative : Saturated Saline.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
3. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Blood.
Preservative : Sodium fluoride.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
4. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Urine.
Preservative : Sodium fluoride.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
5. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen :Saturated Saline (Sample of preservative).

Signature of the Medical Officer

--------------------------- --------------------- --------------------------- ------------------------ -----------------
6. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen :Sodium Fluoride (Sample of preservative).

Signature of the Medical Officer

70
 DUPLICATE
LABEL TO BE ATTACHED TO MATERIAL OBJECTS SENT FOR CHEMICAL
ANALYSIS (Preserved during postmortem examination)
1. P.M. No…………………………………….. Date:…………………………………..
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Stomach with contents and first 30cm of intestine with contents.
Preservative : Saturated Saline.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
2. P.M. No…………………………………….. Date:…………………………………..
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : 500gms of liver and one half of each kidney.
Preservative : Saturated Saline.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
3. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Blood.
Preservative : Sodium fluoride.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
4. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen : Urine.
Preservative : Sodium fluoride.
Signature of the Medical Officer
--------------------------- --------------------- --------------------------- ------------------------ -----------------
5. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen :Saturated Saline (Sample of preservative).

Signature of the Medical Officer

--------------------------- --------------------- --------------------------- ------------------------ -----------------
6. P.M. No…………………………………….. Date:…………………………………….
Name of the deceased:………………………………………… Age……years. Sex: Male/Female
Specimen :Sodium Fluoride (Sample of preservative).

Signature of the Medical Officer

71
 ORIGINAL
Office of the ……………………………..……
………………………..Dated…………………
REPORT TO BE FORWARDED WITH THE MATERIAL OBJECTS SENT FOR
CHEMICAL ANALYSIS (Preserved during postmortem examination)
1) Postmortem No. :………………………………..Dated :………………………………….
2) Name of the deceased:………………………………………………. Age:….years. Sex: M / F.
3) Crime No…………….. of……………………………………………………….. police station.
4) Material objects :
a) Stomach and part of intestine with contents.
b) Part of liver and one half of each kidney.
c) Blood
d) Urine.
e) Saturated saline ( sample of preservative for 1 & 2).
f) Sodium fluoride ( sample of preservative for 3 & 4)
g) ………………………………………………………………………………………
h) ………………………………………………………………………………………
5) Mode of packing : Collected in bottles, wrapped with paper, tied and sealed.

6) Impression seal used : X 7) Copy of labels affixed to bottles / packages: Attached.

8) Alleged cause of death as per inquest :

9) Clinical history,treatment, progress etc., :

10) Postmortem findings in brief:……………….……………………………………………………

……………………………………………………………………………………………………...…
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
………………………………………………………………………………………………………...
11) Examination required: Quantitative and qualitative analysis for drugs / poisons, detected if any

Signature:
Name & Designation:
To,
The Regional Chemical Examiner to Government,……………………………………………...
Sir,
I am forwarding the above mentioned material objects through Sri………………………………..
PC. No……………….. for chemical examination and certificate. I request you that three copies of
your certificate may be sent to me at an early date.
Yours faithfully,
Date:………………….
Place:………………… Signature:…………………………………….
Name :……………………………………
Designation:……………………………………
72
 DUPLICATE
Office of the ……………………………..……
………………………..Dated…………………
REPORT TO BE FORWARDED WITH THE MATERIAL OBJECTS SENT FOR
CHEMICAL ANALYSIS (Preserved during postmortem examination)
1) Postmortem No. :………………………………..Dated :………………………………….
2) Name of the deceased:………………………………………………. Age:….years. Sex: M / F.
3) Crime No…………….. of……………………………………………………….. police station.
4) Material objects :
i) Stomach and part of intestine with contents.
j) Part of liver and one half of each kidney.
k) Blood
l) Urine.
m) Saturated saline ( sample of preservative for 1 & 2).
n) Sodium fluoride ( sample of preservative for 3 & 4)
o) ………………………………………………………………………………………
p) ………………………………………………………………………………………
5) Mode of packing : Collected in bottles, wrapped with paper, tied and sealed.

6) Impression seal used : X 7) Copy of labels affixed to bottles / packages: Attached.

8) Alleged cause of death as per inquest :

9) Clinical history,treatment, progress etc., :

10) Postmortem findings in brief:……………….……………………………………………………

……………………………………………………………………………………………………...…
……………………………………………………………………………………………………...…
………………………………………………………………………………………………………...
………………………………………………………………………………………………………...
11) Examination required: Quantitative and qualitative analysis for drugs / poisons, detected if any

Signature:
Name & Designation:
To,
The Regional Chemical Examiner to Government,……………………………………………...
Sir,
I am forwarding the above mentioned material objects through Sri………………………………..
PC. No……………….. for chemical examination and certificate. I request you that three copies of
your certificate may be sent to me at an early date.
Yours faithfully,
Date:………………….
Place:………………… Signature:…………………………………….
Name :……………………………………
Designation:……………………………………
73
Label to be affixed on the sealed packet for Chemical Analysis of Viscera and other
material objects sent to Chemical Examiner.
Material objects : 1) Stomach, intestine and contents. 2) Part of liver and one kidney
3) Blood. 4) Urine 5) Saturated saline. 6) Sodium fluoride
7) ………………………………………………………………………………
……………………………………………………………………………….
PM. No. …………….……… Date………….…………….
Name of the deceased ;…………………………………………………age:…..yrs. Sex :M/F
Crime No. ……………….of ………………………………………………………police station.
Date:………………………… Signature :
Place:……………………….. Name & Designation :
-----------------------------------------------------------------------------------------------------------------------
Label to be affixed on the sealed packet for Chemical Analysis of Viscera and other
material objects sent to Chemical Examiner.
Material objects : 1) Stomach, intestine and contents. 2) Part of liver and one kidney
3) Blood. 4) Urine 5) Saturated saline. 6) Sodium fluoride
7) ………………………………………………………………………………
……………………………………………………………………………….
PM. No. …………….……… Date………….…………….
Name of the deceased ;…………………………………………………age:…..yrs. Sex :M/F
Crime No. ……………….of ………………………………………………………police station.
Date:…………………… Signature :
Place:…………………... Name & Designation :
-----------------------------------------------------------------------------------------------------------------------
Label to be affixed on the sealed packet for Chemical Analysis of Viscera and other
material objects sent to Chemical Examiner.
Material objects : 1) Stomach, intestine and contents. 2) Part of liver and one kidney
3) Blood. 4) Urine 5) Saturated saline. 6) Sodium fluoride
7) ………………………………………………………………………………
……………………………………………………………………………….
PM. No. …………….……… Date………….…………….
Name of the deceased ;…………………………………………………age:…..yrs. Sex :M/F
Crime No. ……………….of ………………………………………………………police station.
Date:…………….. Signature :
Place:……………. Name & Designation :
-----------------------------------------------------------------------------------------------------------------------

74
 ORIGINAL
PM. No. ……………( dated……………………..). Date : ………………………

FINAL OPINION AS TO CAUSE OF DEATH

As per requisition from the ………………………………………………………………….. of
……………………………………………………. Police station dated ………………………,
postmortem examination was conducted on the body of a male/female by
name………………………..……………….….…………………………….…….. stated to be
aged about ….years, involved in Crime No. …………of ……………….………….………..…
police station and the postmortem certificate No.……… dated ………………… was issued
by the undersigned. The opinion as to cause of death was reserved pending results of
chemical analysis of viscera and other material objects preserved from the body**.
The Certificate of chemical analysis No.………………………..dated…………………
of the above said viscera and other material objects was received by me
on………..……………from the Chemical Examiner to Government.
Laboratory Findings :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion
Based on the postmortem findings and results of Laboratory examinations, I furnish my
Final Opinion as follows :-
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………

Signature :
Place :………………….. Name :
Date : …………………. Designation :
……………………………………………………………………………………………………….
Forwarded to:………………………………………………………………………………….
Copy to:………………………………………………………………………………………..
(** Strike off if not applicable)

75
 DUPLICATE
PM. No. ……………( dated……………………..). Date : ………………………
FINAL OPINION AS TO CAUSE OF DEATH

As per requisition from the ……………………………………………………………….. of

……………………………………………………. Police station dated ………………………,
postmortem examination was conducted on the body of a male/female by
name………………………..……………….….…………………………….…….. stated to be
aged about ….years, involved in Crime No. …………of ……………….………….………..…
police station and the postmortem certificate No.……… dated ………………… was issued
by the undersigned. The opinion as to cause of death was reserved pending results of
chemical analysis of viscera and other material objects preserved from the body**.
The Certificate of chemical analysis No.………………………..dated…………………
of the above said viscera and other material objects was received by me
on………..……………from the Chemical Examiner to Government.
Laboratory Findings :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion
Based on the postmortem findings and results of Laboratory examinations, I furnish my
Final Opinion as follows :-
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………

Signature :
Place :………………….. Name :
Date : …………………. Designation :
……………………………………………………………………………………………………….
Forwarded to:………………………………………………………………………………….
Copy to:………………………………………………………………………………………..
(** Strike off if not applicable)
76
 TRIPLICATE
PM. No. ……………( dated……………………..). Date : ………………………
FINAL OPINION AS TO CAUSE OF DEATH

As per requisition from the ………………………………………………………………….. of

……………………………………………………. Police station dated ………………………,
postmortem examination was conducted on the body of a male/female by
name………………………..……………….….…………………………….…….. stated to be
aged about ….years, involved in Crime No. …………of ……………….………….………..…
police station and the postmortem certificate No.……… dated ………………… was issued
by the undersigned. The opinion as to cause of death was reserved pending results of
chemical analysis of viscera and other material objects preserved from the body**.
The Certificate of chemical analysis No.………………………..dated…………………
of the above said viscera and other material objects was received by me
on………..……………from the Chemical Examiner to Government.
Laboratory Findings :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion
Based on the postmortem findings and results of Laboratory examinations, I furnish my
Final Opinion as follows :-
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………

Signature :
Place :………………….. Name :
Date : …………………. Designation :
……………………………………………………………………………………………………….
Forwarded to:………………………………………………………………………………….
Copy to:………………………………………………………………………………………..
(** Strike off if not applicable)
77
 QUADRAPLICATE
PM. No. ……………( dated……………………..). Date : ………………………
FINAL OPINION AS TO CAUSE OF DEATH

As per requisition from the ………………………………………………………………….. of

……………………………………………………. Police station dated ………………………,
postmortem examination was conducted on the body of a male/female by
name………………………..……………….….…………………………….…….. stated to be
aged about ….years, involved in Crime No. …………of ……………….………….………..…
police station and the postmortem certificate No.……… dated ………………… was issued
by the undersigned. The opinion as to cause of death was reserved pending results of
chemical analysis of viscera and other material objects preserved from the body**.
The Certificate of chemical analysis No.………………………..dated…………………
of the above said viscera and other material objects was received by me
on………..……………from the Chemical Examiner to Government.
Laboratory Findings :…………………………………………………………………………..
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Opinion
Based on the postmortem findings and results of Laboratory examinations, I furnish my
Final Opinion as follows :-
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………

Signature :
Place :………………….. Name :
Date : …………………. Designation :
……………………………………………………………………………………………………….
Forwarded to:………………………………………………………………………………….
Copy to:………………………………………………………………………………………..
(** Strike off if not applicable)
78
 AMBULANCE / CREMATION / BURIAL/ EMBALMING CERTIFICATE
This is to certify that the postmortem examination on the body of a male / female by name
……………………………………..…………………………..….., aged………..years, involved
in Crime No. …………………of …………………………….…………………………….Police
station was done by me on this day of ………..…….. at …………………………….…
…………………………………………………………………………………………………..……

It is also certified that the body has been embalmed, hermetically sealed and is fit for
transportation by air. The embalming fluid contained the following ingredients
………………………………………………………………………………………………………..

This certificate is being issued for the purpose of being produced in relation to cremation /
burial of the body / transportation of the body from ………………………………………….
to ……………………...……………… / for airlifting the body within or outside the country.

Signature:

Place………………… Name :……………………..……………………..

Date:…………………… Designation:……………………………………………

Name of Institution:…………………………………………………………………………………
(Strike off whichever is not applicable)
( 3 copies for airlifting within the country and 5 copies for international transportation)

AMBULANCE / CREMATION / BURIAL/ EMBALMING CERTIFICATE

This is to certify that the postmortem examination on the body of a male / female by name
……………………………………..…………………………..….., aged………..years, involved
in Crime No. …………………of …………………………….…………………………….Police
station was done by me on this day of ………..…….. at …………………………….…
…………………………………………………………………………………………………..……

It is also certified that the body has been embalmed, hermetically sealed and is fit for
transportation by air. The embalming fluid contained the following ingredients
………………………………………………………………………………………………………..

This certificate is being issued for the purpose of being produced in relation to cremation /
burial of the body / transportation of the body from ………………………………………….
to ……………………...……………… / for airlifting the body within or outside the country.

Signature:

Place………………… Name :……………………..……………………..

Date:…………………… Designation:……………………………………………

Name of Institution:…………………………………………………………………………………
(Strike off whichever is not applicable)
( 3 copies for airlifting within the country and 5 copies for international transportation)

79
 ORIGINAL
P.M. No:………………… Dated,…………………….

FORMAT FOR REFERRING A POSTMORTEM EXAMINATION TO POLICE SURGEON

THROUGH INVESTIGATING POLICE OFFICER OR MAGISTRATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the undersigned and the postmortem examination commenced at……………on
…………..…. The alleged cause of death as per inquest was ………………………….
………………………………………………………………………………………………………..
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
On the body, I noted the following:
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………..………………………………………………………………………………………
……………………………………………………………………………………………………….

Based on the findings of external examination, I am of the opinion that this case
requires a detailed examination by Police Surgeon. I also consulted
Dr…………………………………………………………………., Head of this institution who
agreed with me regarding the same. Hence I request you that the case may be referred to
Police Surgeon attached to ……………………………………………………………………….

Signature :
Name :……………………………………
Designation :…………………………………….
I agree with the opinion of Dr………………………………………….., for referring this
case to Police Surgeon and to sanction the expenses for transportation of the dead body .

Signature :
Date :…………………… Name :……………………………………
Place :………………….. Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..
80
 DUPLICATE
P.M. No:………………… Dated,…………………….

FORMAT FOR REFERRING A POSTMORTEM EXAMINATION TO POLICE SURGEON

THROUGH INVESTIGATING POLICE OFFICER OR MAGISTRATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the under signed and the postmortem examination commenced at……………on
…………..…. The alleged cause of death as per inquest was ………………………….
………………………………………………………………………………………………………..
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
On the body I noted the following
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………..………………………………………………………………………………………
……………………………………………………………………………………………………….

Based on the findings of external examination, I am of the opinion that this case
requires a detailed examination by Police Surgeon. I also consulted
Dr…………………………………………………………………., Head of this institution who
agreed with me regarding the same. Hence I request you that the case may be referred to
Police Surgeon attached to ……………………………………………………………………….

Signature :
Name :……………………………………
Designation :…………………………………….
I agree with the opinion of Dr………………………………………….., for referring this
case to Police Surgeon and to sanction the expenses for transportation of the dead body .

Signature :
Date :…………………… Name :……………………………………
Place :………………….. Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..

81
 TRIPLICATE
P.M. No:………………… Dated,…………………….

FORMAT FOR REFERRING A POSTMORTEM EXAMINATION TO POLICE SURGEON

THROUGH INVESTIGATING POLICE OFFICER OR MAGISTRATE.
The requisition for postmortem examination on the body of a male / female by name
……………………………………………………………………………….… stated to be aged
……years, involved in Crime No…………… of ..……………………………………………….
police station was received from.………………………………..……………………..………
at.…………….on……..…………(vide his letter Cr. No………….dated…………………).
The body was in charge of P.C. No………… who identified the same. The body was first
seen by the under signed and the postmortem examination commenced at……………on
…………..…. The alleged cause of death as per inquest was ………………………….
………………………………………………………………………………………………………..
(To be exactly reproduced from the relevant column in the requisition for postmortem examination KPF 102)
On the body, I noted the following:
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………..………………………………………………………………………………………
……………………………………………………………………………………………………….

Based on the findings of external examination, I am of the opinion that this case
requires a detailed examination by Police Surgeon. I also consulted
Dr…………………………………………………………………., Head of this institution who
agreed with me regarding the same. Hence I request you that the case may be referred to
Police Surgeon attached to ……………………………………………………………………….

Signature :
Name :……………………………………
Designation :…………………………………….
I agree with the opinion of Dr………………………………………….., for referring this
case to Police Surgeon and to sanction the expenses for transportation of the dead body .

Signature :
Date :…………………… Name :……………………………………
Place :………………….. Designation :…………………………………….
Name of Institution : ………………………...………………………………………………..……
Forwarded to :……………………………………………………………………………………….
Copy to :……………………………………………………………………………………………..

82
 Form of Application cum No Objection Certificate
(For issue of Postmortem Certificate, to the legal heirs of the deceased)

Name of the Applicant:……………………………………………………………………………

Address :……………………………………………………………………………………………
………………………………………………………………………………………………………..
Relation of the applicant to the deceased :……………………………………………………………
Date of PM examination :………………………… Crime No.:………………………………..
Name of police station :………………………………………………………………………………
Reason for applying for copy of the certificate :…………………………………………………….
………………………………………………………………………………………………………..
Place :…………………….
Date :……………………. Signature of the applicant.
------------------------------------ -------------------------------------------- ------------------------------------
Certificate
I, the Investigating Police Officer of Crime No……………………………………of
………..…………………………………………………..……. police station, hereby certify that
there is no objection in issuing to the applicant, a copy of the Certificate of Postmortem
examination conducted on the body of …………………………………………...…………………,
aged ………..years, involved in the abovesaid crime.

Place:…………………….. (Seal)
Date :……………………. Signature & Designation of the Officer.
--------------------------------- ---------------------------------------------- -------------------------------------
For Office Use only
Verified Ration Card No…………………Applicant is A.P.L. / B.P.L.**(Strike off whichever is not applicable)
Remitted Rs…………….….(…………………………………….………………………………) as
per Receipt No……………………dated……………………………(For A.P.L. card holders only)

Issued the copy of Postmortem Certificate :

Signature of the Issuing Officer

Received the copy of Postmortem certificate :

Signature of the Applicant

83
 Form of Application cum Certificate of Authenticity
(of the copy of Postmortem certificate, for the purpose of Insurance claim)

Name of Insurance Company :……………………………………………………………………..

Reference Policy / Claim No. :……………………………………………………………………..
Postmortem Number and date.:……………………………………………….……………………
Name of the deceased :……………………………………………Age:….years Sex:Male/Female
Address (as recorded in Postmortem Certificate):……………………………………………………
……………………………………………………………………………………………………….
Ref. Crime No.:………………of …………………………………………..………...police station
Name & Designation of doctor who conducted Postmortem examination :……………...………….
………………………………………………………………………………………………………..
Name of institution:………………………………………………………………………………….

It is requested that the authenticity of the copy of abovesaid Postmortem Certificate, produced
alongwith this application, which was submitted to us for the purpose of Insurance Claim, may be
certified and the copy of the certificate attested and returned to us at an early date.

----------------------------------- --------------------------------------------- -------------------------------------

Certified that, I, Dr………………………………...………………………………, working as

……………………………………………… attached to ………………...…………………………
……………………………..have conducted postmortem examination on the dead body of a male /
female, by name ………………………………………………………………, aged ……..years,
involved in Crime No…………………. of ……………………………..….………………………..
police station, on ………………………... and issued the Postmortem Certificate No………….…..
dated…………………………. Copy of the certificate is attested and returned along with.

Place :………………. Signature :

Date :………………. Name :
: (Seal) Registration No.:
Designation :
Name of Institution :………………………………………………………………………………….

84
 Annexure – II

MEDICO-LEGAL POST MORTEM EXAMINATION – GUIDELINES

(Modified version of guidelines prescribed as per G.O. (MS) 122/84/Home (H)

Dept, Trivandrum, dated 04-09-1984)
 MEDICO-LEGAL POST MORTEM EXAMINATION – GUIDELINES
(Modified version of guidelines prescribed as per G.O. (MS) 122/84/Home (H) Dept,
Trivandrum, dated 04-09-1984)
I) Introduction :
Medical Officers who are authorized to conduct a medico legal autopsy are
directed to go through the following guidelines. They are advised to refer a standard
textbook to understand the procedure and technique of conducting the autopsy. A
meticulous external examination and a detailed internal examination must be carried out
in every case with the following objectives in mind.
(a) To find out the cause of death.
(b) To find out the approximate time since death.
(c) To help establish the identity of the deceased, in cases where it is unknown.
(d) To find out the position of body after death.
(e) To collect relevant information to assist the investigating Officers to arrive at a
conclusion whether death is accidental, suicidal or homicidal.
(f) In case of infants whether it is live born / still born / dead born and if live born the
period of survival and the cause of death.
II). Procedural Formalities:
1) The examination can be undertaken only on receipt of a written requisition in the
prescribed form (K.P.F. No. 102) from a competent authority (Police Officer /
Magistrate).

2) An extract of the inquest report, relevant to post-mortem examination, should be

insisted upon along with the requisition.

3) In cases with a history of treatment of any sort before death, the case sheet should
be perused and relevant points regarding findings at admission, results of
investigation, treatment given, surgical and other procedures performed etc.,
should be noted in the detailed notes.

4) Clothes and other material objects found on the body are to be asked for, in all
cases where examination of such material objects may help in attaining any of the
objectives of autopsy.

5) A receipt should be issued to the charge police constable, for the dead body
received for postmortem examination (For example from See Annexure - I).
6) The Police Constable in charge of the dead body should be made to identify the
dead body as that of the deceased person involved in the particular crime and for
which the requisition is obtained.

7) Examination should be undertaken as early as possible.

8) No unauthorized person shall be allowed to enter the post-mortem room.

9) The autopsy findings are to be recorded then and there in the post-mortem
detailed notes.

10) Postmortem certificate incorporating the relevant findings is to be prepared in

quadruplicate. The original is to be dispatched to the concerned Court and copy to
the concerned investigating officer. (For example from See Annexure - I).

11) Viscera, blood and urine are to be preserved in suspected cases of poisoning and
if the cause of death of uncertain. These material objects are to be dispatched to
the Chemical Examiner to the Government (For example form – See Annexure - I).

12) Bits of relevant internal organs are to be preserved in Formalin when death is
suspected to be due to natural disease. These samples are to be sent to the
Pathology Department of the nearest Medical College or General/District hospital,
where there is facility for Histo-pathological examination, through police. The
medical officer in charge of the Pathology Department of the particular institution to
which such request is made, shall not refuse to undertake such request for histo-
pathological examination, on any reasons and should undertake such examination
free of any sort of fee. The report of histo-pathological examination from the
Pathology Department, need not be submitted to the Investigating Police Officer or
concerned Court. The doctor who requested such histo-pathological examination
should prepare a report incorporating the findings and conclusions of the
examination. Issue of this report should be in the same line as that of Postmortem
Certificate.

13) Sample of blood is to be collected for purposes of grouping in murder cases. A

fitter paper can be used for this purpose. In institutions with facility for blood
grouping, such as blood bank etc, the grouping should be done there itself, with
5ml of blood collected in glass bottle. In the event of the result of such examination
being inconclusive, the shade dried, filter paper sample need to be handed over to
the investigating officer.
14) In cases where the viscera are preserved for chemical or histo-pathological
examination, the cause of death can be reserved pending the results of such
examinations. Upon receipt of the results of laboratory investigations, the final
opinion is to be furnished on the basis of the postmortem examination and
laboratory findings (For sample form – See Annexure - I). However, if the Medical
Officer finds and identify a particular type of poison in the stomach and if he is
convinced that the findings of the postmortem examination are consistent with
death due to the particular type of poison and also if he can reasonably rule out
other causes of death, possible within the limits of a complete medico-legal
postmortem examination, he can furnish the opinion as to cause of death as
consistent with poisoning, with the particular type of poison. E.g., Insecticidal
Poisoning, Corrosive Acid Poisoning etc.

15) As per the provisions of sec.161 of Cr.P.C., the Medical Officer is bound to give a
statement regarding the autopsy findings to the Investigating Officer, immediately
on completion of the postmortem examination (162 statement). Expert opinion
furnished with reference to the case is to be recorded in the detailed post-mortem
notes for future reference.

16) All documents and material objects connected with post-mortem examination are
to be kept under safe custody to avoid loss and to prevent tampering.

17) Post-mortem findings are to be kept strictly confidential. The legal heirs of the
deceased can however claim the fourth copy of the postmortem certificate
provided the Investigating Officer or the Court issues a no-objection certificate to
this effect. A fee of Rs.25 has to be remitted to the Government by the legal heirs
for obtaining the copy of the certificate.

III). General Guidelines :

1) Adequate protective measures in par with the specifications of Universal

Precaution should be adopted.

2) Make sure that necessary entries are made in the Postmortem Register and the
signature of the charge police constable is obtained.

3) All postmortem examinations should be serially numbered, in every calendar year

and the number/year and date of examination should be entered in the detailed
notes and should be recorded at the top end of the postmortem certificate(e.g.
01/08 Dated 01-01-08 …..).
4) All the columns in the front page of the detailed notes (For sample form, See
Annexure - I) should be properly filled in with a view to recording the same in the
pre-amble portion of the postmortem certificate (For sample form, See Annexure -
I), under the main heading POSTMORTEM CERTIFICATE.

5) Make a complete and thorough external examination, as per the guidelines

enlisted hereafter under subheading A. General and they should be recorded in
the postmortem certificate under subheading A.General.

6) If there are ante-mortem injuries on the body, they should be described in detail in
the postmortem certificate, under subheading Injuries (Ante-mortem), as per the
guidelines enlisted hereafter under subheading B.Injuries (Ante-mortem).

7) In cases of death due to neck violence (Hanging, Strangulation etc), neck findings
should be recorded in the postmortem certificate under subheading Neck, as per
the guidelines enlisted hereafter under subheading Cases of Neck Violence. If
there are ante-mortem injuries in such cases of death due to neck violence, on
areas other than neck, they should be described in the postmortem certificate
under separate subheading Injuries (Ante-mortem), as per the guidelines enlisted
hereafter under subheading B.Injuries (Ante-mortem).

8) If there are postmortem injuries on the body, they should be described in detail and
in the same manner prescribed for ante-mortem injuries, under a separate
subheading Injuries (Postmortem) and each injury should be serially numbered.

9) In cases where the identity of the deceased is unknown, identifying features should
be recorded under a separate heading Identifying Features, as per the guidelines
enlisted hereafter under subheading Identifying features in cases of Unknown
Identity.

10) In cases where there are no injuries, either external or internal, on any part of the
body including the neck region, after recording the findings of external examination
under subheading A. General, findings of internal examination should be recorded
in detail, under subheading B. Internal. In cases where there are injuries on the
body, or neck findings, which are to be recorded under a separate subheading
B.Injuries or B. Neck, the findings of internal examination may be recorded under
subheading C. Other findings.
11) Opinion as to cause of death should be furnished in par with the internationally
prescribed norms. Asphyxia should not be given as the cause of death in any case,
because it is a mode of death and not a cause of death.

12) In death due to injury/injuries, the cause of death should be furnished as due to the
particular injury/injuries. The injury/injuries noted by the doctor should be sufficient
to cause death in the ordinary course of nature when cause of death is furnished
as due to the particular injury/injuries. When death occurred after some period
extending to days, weeks or months of sustaining the injury and not due to the
direct effect of injury, but due to one or other complications of injury, opinion as to
cause of death should be furnished as due to the complications of injury/injuries
sustained. The dictum to be followed in such cases is that, whether the person
would have led a normal life, but for the injury.

13) In cases of unnatural deaths where asphyxiation is the predominant mode of dying,
like hanging, poisoning, drowning etc., the cause of death may be furnished in any
of the three following manner :-

a) When there are all the conclusive or pathognomonic signs or findings of death
due to a particular cause of death and the possibility for all other causes of
death can be reasonably ruled out within the limits of a complete medico-legal
postmortem examination, opinion as to cause of death should be furnished as
the deceased died due to the particular cause of death.

b) When there are some findings or signs of death due to a particular cause of
death and the possibility for all other causes of death can be reasonably ruled
out within the limits of a complete medico-legal postmortem examination,
opinion as to cause of death should be furnished as postmortem findings are
consistent with death due to the particular cause of death.

c) When there are no findings or signs of death due to the alleged cause of death
and the possibility for all other causes of death can be reasonably ruled out
within the limits of a complete medico-legal postmortem examination, opinion
as to cause of death should be furnished as postmortem findings are not
inconsistent with the history of death due to the alleged cause of death. In such
cases, viscera and other material objects as may be necessary to rule out other
possibility, should be mandatorily preserved.
 d) Whenever opinion as to cause of death is reserved pending the results of
chemical analysis or other such examinations, the causes of death that were
ruled out by medico-legal postmortem examination should be incorporated in
the opinion part.

14) When there are findings of more than one category of cause of death, both or all
sufficient to cause death independently in the ordinary course of nature, both or all
have played their role in the causation of death and the examiner is unable to
decide as to which is the terminal event, he should furnish the opinion as to cause
of death as due to combined effects of both or all other causes of death.

15) Postmortem certificate should bear, just below the opinion, the signature and name
of doctor who has conducted the examination, his/her designation and the name of
Institution, recorded in a legible manner, at the right-hand bottom portion. At the
left-hand bottom portion, date and place should be recorded. Postmortem
certificates are written on the day of postmortem examination itself and hence,
date recorded at the bottom should be the same as that of the date of postmortem
examination. Office seal of the Police Surgeon / Department / Institution should be
mandatorily affixed at the bottom portion of the certificate. When there is more than
one page for the postmortem certificate, each page should be serially numbered
and each page should bear the signature, name and designation of the doctor and
office seal of the institution.

A. General

1. The clothes are examined for evidence of injury, struggle and stains and handed
over to the investigating officer after examination.

2. Bloodstains, seminal stains, mud, sand other foreign particles present on the body
are described.

3. Features of identify such as age, sex, height, weight, nutrition, complexion, hair,
mole, tattoo, marks, dental details, deformities, personal belongings etc. are
described in detail in cases where the identity has not been established.

4. Eyes are examined with specific attention to whether closed or open, black eye or
injuries, cornea, conjunctivae and pupils.

5. Other orifices (nostrils, ears, mouth, urethra, anus and vagina) are examined for
discharge, foreign bodies, injuries and other abnormalities.
6. Colour of nails is noted.

7. Venous puncture marks, semicircular contusions of external cardiac version etc.,

suggestive of treatment prior to death should be noted.

8. Bite marks should be noted in cases due to alleged snakebite.

9. All external findings that can be expected in death due to different types of cause
of death, as described later, should be noted.

10. Evidence of sexual assault is looked for in female dead bodies (a) vulva and
vagina examined for presence of injury, semen, foreign body etc. (b) Hymen
examined for recent / old tear (c) Vaginal swabs collected to look for semen and
also for DNA fingerprinting.

11. State of rigor mortis and its distribution are noted.

12. Post-mortem staining is noted with reference to its extent, position, and the state of
fixation.

13. The degree of decomposition, if present, is observed and indicated as shown

below :

(a) Greenish discolouration of right iliac fossa.

(b) Greenish discolouration of entire abdomen and chest.
(c) Distension of abdomen
(d) Marbling of skin
(e) Protrusion of tongue and eyeballs.
(f) Blood stained forth at the mouth and nostrils.
(g) Blisters and peeling of cuticle
(h) Bloating of face, neck, breast/penis, scrotum /vulva
(i) Regurgitation of stomach contents.
(j) Prolapse of rectum and faecal discharge.
(k) Prolapse of uterus and expulsion of foetus.
(l) Maggots.
(m) “Degloving”
(n) Loosening of hair
(o) Loosening of nail
(p) Collequative putrefaction
14. Surgical intervention and other such therapeutic procedures are identified and
described by referring the clinical notes.
15. Presence of Adipocere/mummification is looked for and described if present.

B. Injuries (Ante-mortem)

1) All injuries (ante-mortem and postmortem) are examined in detail, using

magnifying glass whenever necessary.

2) All injuries should be serially numbered. External and internal injuries should be
recorded under separate subheading and numbered separately.

3) The prescribed pattern of recording of injuries in the sequence of type of injury,

size, placement (vertical, transverse, oblique etc.), site of injury and distance from
anatomical landmarks. Whenever necessary, other details of injuries like direction,
edges, ends, surrounding area, foreign bodies etc. are described.

4) All injuries should be marked in the diagram, provided in the details notes.

5) If injuries are not fresh, color and appearance of scab, stage of scarring etc.,
should be noted. If infected colour, smell etc of slough should be noted.

6) Internally, if there is collection of blood in any of the body cavity, caused by the
injury, the quantity of blood should be measured. If there are clots, the weight of
such clots should be measured.

7) If the injuries are fresh, it should be noted in the postmortem certificate, at the end
of detailed description of injuries. If the injuries do not appear fresh, their
approximate age by appearance should be noted.

(C) Internal Examination

1. An incision from top of one ear to the top of other ear is made.

2. Scalp is reflected towards front and backwards and examined for injuries, mainly
contusions.

3. The vault is examined for fracture. The type of fracture is described in detail. The
vault is removed, ideally using an autopsy saw.

4. The dura is examined for tear. Extradural hemorrhage, if present, is measured and
described.

5. Incision is made on dura on the front and sides, along the removal of skullcap, and
the dura is reflected backwards.

6. Subdural and subarachnoid spaces are examined for collection of blood/fluid/pus.

7. Appearance of the leptomeninges the described.

8. Brain is removed and examined by dissection, for the following :-

(a) Signs of increased intracranial tension – Flattening of gyri, obliteration of sulci,

herniation of tonsillar part, tentorial grooving.

(b) Basal vessels are examined and described.

(c) The substance of brain is examined for softening, injury, haematoma, tumour,
cyst and infection.

9. Stripping of the dura is done and fractures in the base of skull if any, described in
detail.

10. Midline incision from chin to pubis is made, avoiding the umbilicus.

11. Skin is reflected to either side and subcutaneous tissues of neck are examined for
any blood infiltration.

12. Skin and soft tissues on front of chest is examined for the presence of contusions,
blood infiltrations or any other injuries. Pneumothorax if suspected is tested before
opening the chest wall.

13. Peritoneal cavity is opened, holding left index and middle fingers of the examiner
inside the peritoneal cavity and cutting the abdominal wall between them so as to
avoid injury to abdominal viscera.

14. Blood, fluid, pus or any other such content of the peritoneal cavity is described
and measured. Coils of intestines are examined in situ.

15. The proximal end of the free portion of duodenum is cut and the entire coils of
small intestine followed by large intestine are removed.

16. Stomach and its contents are removed together, ideally cuts at both ends being
made between ligatures.

17. Sterno-clavicular joints are cut followed by the costal cartilages on both sides and
sternum is removed. Fluid, blood or any such contents present in the chest cavities
are measured and described.

18. Diaphragm is cut along the costal margins up to its attachment to spinal column.

19. The floor of mouth is cut along the inner border of lower jaw and the tongue is
caught hold of. The neck structures are released from their attachments, pleural
 ligaments on either side cut and the neck structures along with the entire thoracic
and remaining abdominal viscera is removed en mass (En mass evisceration).
Dissection is done after separating the individual organs in the prescribed scheme.

20. The spinal column, rib cage, abdominal cavity, pelvic cavity and bony pelvis
examined for injuries or other abnormalities.

21. Pharynx and larynx are examined for injuries and presence of foreign bodies.

22. Neck structures including hyoid bone, thyroid and cricoid cartilages and tracheal
rings are examined to look for evidence of extravasations of blood, fracture and
other injuries. The type of fracture of hyoid bone (abduction / adduction) is noted.

23. Oesophagus is opened and examined for presence of varices, corrosion and other
abnormalities.

24. Air passage is exposed and examined for presence of soot, sand, mud, weed, forth
etc., up to the smallest division.

25. Lungs are examined with reference to weight, volume, and consistency.
Congestion, edema, natural disease and injury.

26. Contents of the pericardial sac are measured and described.

27. Heart is examined in details and the following are noted;

(a) Weight

(b) Condition of walls, chambers and valves.

(c) Coronaries are examined by serially dissecting at 5mm. Intervals to locate

thrombus, atheroma and hemorrhage Patency / occlusion of lumen is
described. The entire heart is preserved in Formalin after dissection for
microscopic examination when cardiac pathology is suspected.

(d) The presence of air embolism / thrombo embolism is looked for in suspected
cases indicative of them.

(e) Condition of aorta and its branches is carefully described.

28. Liver, Spleen, kidneys, pancreas and adrenals are dissected out and examined for
evidence of natural disease, injuries and poisoning.
29. Stomach removed is dissected. The contents are examined and described as to
the nature, degree of digestion, smell, foreign particles, colour and quantity,
condition of stomach wall is described.

30. Urinary bladder is opened and urine is measured and described.

31. In females, uterus and its appendages are dissected out. Evidence of pregnancy /
miscarriage, if any is looked for and described.

32. Testicles are exposed and examined for injury and disease.

33. No internal organ is left undissected and unexamined.

34. Skeletal system is examined for evidence of violence. The stage of repair is noted.

35. Organs, which warrant microscopical examination, are collected and preserved in
formalin.

36. Viscera, blood and urine may be preserved in cases of suspected poisoning,
alcoholic intoxication and if the body is decomposed.

Poisoning Cases.

1. Any Special smell in the body and viscera is recorded.

2. Colour of postmortem staining is described.

3. Nature of forth is described.

4. Colour of sclera, lips and nails is noted.

5. Mouth and surrounding area are examined for presence of corrosion.

6. Injuries, suggestive of forceful administration of poison, are looked for especially

circum-oral region with special reference to nail marks, inner aspects of lips and
cheeks, neck region and the limbs to look for evidence of attempt to restrain the
victim.

7. Fang marks/ injection marks are noted and tissues from the site are preserved in
rectified spirit for analysis.

8. The G.I tract is examined in detail. Description of stomach (Nature of wall, colour,
corrosion, ulcers, hemorrhage, perforation) and contents (nature, colour quantity
and smell) are entered in the post-mortem notes.

9. The following viscera are collected for purpose of chemical analysis:-

 (a) Stomach in full and 30 cm. of upper part of small intestine with their
contents.
(b) 500 gm. of liver and half of each kidney.
(c) Blood (5-10 ml)
(d) Urine (30 ml.)
10. Preservative is added to the bottles [saturated sodium Chloride solution for item (a)
and (b) and sodium fluoride (100 mg / 10 ml ) for item (c) and (d) ]. Labels are
pasted on the bottles and sealed.

11. Sample of preservative and wax seal impression together with a copy of label on
the viscera bottles are forwarded to the Chemical Examiner.

12. The viscera are forwarded to the Chemical Examine to Government in accordance
with the stipulations of Kerala Chemico – legal Examination Rules, 1959 as
amended up to 30-6-1983 (For sample form see Appendix III & IV)

Hanging / Ligature Strangulation

1. Salivary dribble marks are looked for and their position, extent and direction are
described.

2. Condition of eyes and pupils is described.

3. Colour of lips and nails is mentioned.

4. Position to tongue recorded.

5. Distribution of postmortem staining is described and condition of fixation is

assessed. Stasis petechiae on lower limbs if present, should be noted.

6. Injuries present on the body are described and correlated whether or not they can
be resulted during the process of suspension.

7. Bloodstains on the body are described and their source is located and recorded.

8. The ligature material is described as regards is nature, position and type of knot,
circumference of loop length of short and long free ends, foreign bodies, stains etc.
The materials are returned to the investigating officer without disturbing the knot. A
recommended pattern is “Ligature made of ………… is seen tightly/loosely
around………part of neck with a ………..(type of knot) on ………..side, the long
free portion measuring…….cm, short free portion……..cm and portion around
neck……….cm.
9. The ligature mark is described in detail with reference to its pattern, nature,
direction, extent (complete or incomplete) and correlated with the material if
available. The situation of the mark is measured in relation to chin, ears and
occipital protuberance. The recommended pattern is “ A pressure abrasion with
…………………base (dry, parchmented, pale etc.,) and of size …….x…..to…..cm
(e.g. 25x1 to 2cm) was seen coursing upwards and backwards from at and above /
at / at and below thyroid cartilage in midline front of neck, ……….cm below chin
(breadth….cm) to its right end at ………..cm behind right ear lobule
(breadth…..cm) and to its left end at ………cm behind left ear lobule (breadth
….cm0

10. Neck is dissected in detail in “bloodless field”. Here brain is removed as described
earlier. Thoracic and abdominal viscera are removed by a midline incision from
sternal notch to pubis. Thai leaves the neck region almost free of blood retained in
the vessels. Then the neck structures are removed and examined, as described
earlier. Soft tissues are examined for injuries and extravasations of blood. Hyoid
bone, thyroid cartilage, cricoid cartilage and tracheal rings are examined for
fracture and described. Injury to cervical spine and cord is looked for.

11. Internal organs are examined for the presence of injury, disease and poison.
12. Viscera may be preserved in suspicious cases, cases of suspected poisoning and
in advanced decomposition.
Bodies recovered from water
1. Signs of submersion – soddening, washerwoman’s hand and feet cutis anserine,
etc., are described.
2. Froth at the mouth and nostrils are described as regards its nature, colour,
quantity.
3. Presence of cadaveric spasm is looked for.
4. Injuries on the body are described for reconstruction purposes.
5. Air passage is opened and searched for parties of sand, mud, weed and other
foreign material up to the smallest division possible.
6. Lungs are examined in detail as regards the weight, tardieu spots, and appearance
in general and on cut section.
7. Fluid in the chest cavities is measured and described.
8. Stomach and intestines is examined and its contents are described, especially with
reference to the alleged drowning medium.
 9. All the internal organs are examined for presence of injury, disease or poison.
10. Viscera are collected for chemical analysis in decomposed bodies and if the cause
of death is uncertain. Bone marrow of sternum should be preserved for diatom test.
In decomposed dead bodies without any positive evidence of drowning, bone
marrow should be mandatorily preserved.
Burns Cases
1. Smell of kerosene/other inflammable agents on the body and clothes is recorded.
2. Pugilistic or partial pugilistic attitude of the body, if present should be noted.
3. Singeing of hairs, soot staining and deposition of carbonaceous particles on teeth,
soot staining of discharge from nostrils etc., may be described in detail.
4. Nature of burn (ante–mortem / postmortem) decided by observing vital changes.
5. The extent of burns and its degree are described. Peeling of cuticle, extent of
charring, heat ruptures etc., should be noted.
6. Age of the burn is ascertained from the stage of healing.
7. Injuries other than burns are described in detail.
8. Colour of post-mortem staining is described.
9. Air passage is examined for the presence of soot particles using a cotton swab.
10. The colour of blood is described. If necessary, blood may be preserved to look for
carboxyhaemoglobin.
11. Evidence indicating poisoning, pregnancy, abortion, sexual assault, natural
disease is noted and preserved.
12. Charred remnants of skin, cloth, hair etc., may be preserved to look for
inflammable substances and the products of their combustion.
Abortion
1. Evidence of pregnancy (size of uterus, uterine contents, breast changes etc…) is
established.
2. Period of gestation is assessed by examining the size of the uterus and
development of the products of conception.
3. Evidence of mechanical interference for procuring abortion is noted and preserved.
4. Evidence of toxic substances used for inducing abortion is looked for. The uterus,
vagina and their contents may be collected and preserved for chemical analysis.
5. Evidence of sepsis, emboli and other complications of abortion is looked for.
Traffic Accidents
1. Injuries are measured and described.
2. The position of injuries in relation to the heel is noted for reconstruction purposes.
3. Foreign particles found on the body are collected and preserved.
4. Samples of blood and urine should be preserved for analysis, in all cases death
within twenty for hours of the accident.
5. Eyes are examined for evidence of defective vision.
Examination of Foetus / New Born Infant
1. Clothes and other wrappings are examined & handed over to investigating Officer.

2. Vernix caseosa if present, should be looked for.

3. Look for findings, which may suggest assisted delivery, hospital delivery or
unattended delivery.

4. Postmortem changes are described in detail.

5. Sings of maceration / mummification are looked for and described.

6. Congenital malformation (if any) is noted.

7. Umbilical cord is examined with reference to ligature, signs of inflammation and

mummification.

8. The details of placenta (if present) are described.

9. The caput succedaneum is searched for and located.

10. Marks of violence when present are described.

11. Intra uterine age of the foetus is ascertained by observing the following:-

(a) Crown heel length is measured and the age is estimated applying
Hesse’s Rule.
(b) Weight of the foetus.
(c) The extent of nails in relation to finger tips.
(d) The length and texture of scalp hair.
(e) Presence / absence of eyebrows and eyelashes.
(f) Condition of eyelids – adherent / open.
(g) Position of testicles in case of males.
(h) Ossification centre in the lower end of femur, upper end of tibia, manubrium,
body of sternum, calcaneum, talus and cuboid.
12. Scalp is examined for bruising.

13. Skull bones examined for fracture.

14. Brain and meninges are examined and described.

15. Air passages are examined for foreign bodies.

16. Hydrostatic test is performed and inference recorded.

17. The lung examined with reference to its weight, colour, consistency, edges
crepitation, collapse, consolidation and mottling.

18. Stomach is examined for the presence of milk.

19. Intestine is examined for the presence of meconium.

20. All internal organs are examined to locate evidence of violence, poisoning and
natural disease.

21. Bits of lungs are preserved in 10 % formalin for histopathological examination in

cases where a definite opinion is not formed from hydrostatic test.

22. Viscera are preserved in suspected cases of poisoning and if the cause of death
could not be established in live born babies.

Fire Arm Injury Cases.

1. Clothes of the deceased are examined and described with reference to injuries,
burn marks, blackening, tattooing stains due to grease, mud, blood, etc.
Examinations is made with due precautions to prevent loss of trace evidences.

2. Clothes are returned to the investigating officer with directions to submit them to
Ballistic section of Forensic Science Laboratory.

3. The dead body is subjected to radiological examination, wherever facilities permit,

to locate the bullet / pellet.

4. Presence of Cadaveric spasm is looked for.

5. Hands are examined for presence of gunpowder residues, swabs from the hands
are collected and preserved for chemical tests before washing the body.

6. Bloodstains on the body are described to the extent of their position, area involved,
directions of flow etc.

7. Foreign bodies found on the body are clearly described and preserved.

8. The injuries found on the body are examined in detail with reference to

1. Number
2. Size
3. Shape
4. Situation
5. Edges
6. Surrounding skin for abrasion collar, grease collar, burning, blackening,
tattooing and blast effects.
7. Diameter of dispersion of pellets in case of shotgun / country gun wounds.
 8. Direction of wound track.
9. Foreign bodies – Wad, bullet / pellet.
10. Colour of subcutaneous tissues and muscle.
9. Skin around the wound is dissected and preserved in rectified spirit for
transmission to ballistic section of Forensic Science Laboratory.
10. The projectiles (bullet, pellet, fragments ) found in the body are collected with due
care to avoid scratches by picking them with cotton wool.
11. An identification mark is put at the base of the bullet for future reference.
12. No effort is made to clean the bullet / pellet and they are packed and labeled
before handing over to the Investigating Officer for transmission of Forensic
Science Laboratory.
Identifying features in cases of Unknown Identity :
1) Clothes and available personal belongings should be thoroughly examined for any
documents or such other things, which may give a clue to the identity of the
person.
2) Tailor marks, dhobi marks etc., on the cloths should be examined.
3) Height, build and nourishment and complexion should be noted.
4) Hairs on the scalp and body should be described. Length of hair, appearance
(whether curly, straight, etc.,), percentage of graying, type of growth (whether thick,
thin or sparse etc.,), pattern of baldness if present and al such details should be
noted with regard to hairs on scalp, face, front of chest and pubic region. Any
peculiar feature that might attract the attention of others, if present may be
described.(e.g., hairs growing from pinna of ears, thick upward growth of hairs on
front of chest, beyond the sternal notch etc.,).
5) Dentition should be described in detail, in the prescribed manner. Any peculiar
feature that may attract the attention of others like, forward protrusion of front
teeth, malalignment of any front teeth, broken teeth in front row etc., may be noted.
Degree of attrition and periodontosis of teeth may also be noted.
6) Ear lobules or nostrils, if punctured, the same should be noted.
7) Tattoo marks, scars of injury or surgical procedures, callosities etc., if present,
should be noted.
8) Any particular feature, which may suggest the occupation of the person, if present,
should be noted.
9) Condition of nails whether grown, trimmed, irregularly trimmed etc., should be
noted.
10) Any particular features which may suggest the habits of the person, like tobacco or
pan staining of teeth, multiple dot like scars of venous or dermal puncture in drug
addicts etc should be noted.
11) Whether circumcised or not, should be noted.
12) In females, striae gravidarum, scar of PPS etc., should be noted.