Second MBBS FMT Syllabus 030621

Course Content
PHASE II
Subject: Forensic Medicine & Toxicology
Second Professional
Theory / Practical
(Based on National Medical Commission, India, Competency based Undergraduate curriculum for the
Indian Medical Graduate, 2018. Vol. 1; page nos. 228 -251)
FORENSIC MEDICINE AND TOXICOLOGY
1. Goals
The broad goal of the teaching of undergraduate students in Forensic Medicine is to produce a physician
who is well informed about medicolegal responsibilities in practice of medicine. He /She will also be
capable of making observations and inferring conclusions by logical deductions to set enquiries on the right
track in criminal matters and connected medicolegal problems. He /She acquires knowledge of law in
relation to medical practice, medical negligence and respect for codes of medical ethics
2. Objectives
2. (a) KNOWLEDGE:
At the end of the course, the student should be able to:
1. Identify the basic medicolegal aspects of hospital and general practice.
2. Define the medicolegal responsibilities of a general physician while rendering community service either
in a rural primary health center or an urban health center.
3. Appreciate the physician's responsibilities in criminal matters and respect for the codes of medical
ethics.
4. Diagnose, manage and identify also legal aspects of common acute and chronic poisonings.
5. Describe the medicolegal aspects and findings of post-mortem examination in case of death due to
common unnatural conditions & poisonings.
6. Detect occupational and environmental poisoning, prevention and epidemiology of common poisoning
and their legal aspects particularly pertaining to Workmen's Compensation Act.
7. Describe the general principles of analytical toxicology.
8. Medical jurisprudence in view of the Consumer Protection Act – wherein doctors have been
covered under its ambit. They have both rights as well as responsibilities. Under medical insurance
acts of negligence covered as well as rights for effective service delivery.
2. (b) SKILLS
At the end of the course, the student should be able to: -
1. Make observations and logical inferences in order to initiate enquiries in Criminal matters and
medicolegal problems.
2. Diagnose and treat common emergencies in poisoning and manage chronic toxicity.
3. Make observations and interpret findings at postmortem examination.
4. Observe the principles of medical ethics in the practice of his profession.
2. (c) INTEGRATION
Department shall provide an integrated approach towards allied disciplines like Pathology, Radiology,
Forensic Sciences, Hospital Administration etc. to impart training regarding medicolegal responsibilities of
physicians at all levels of health care. Integration with relevant disciplines will provide scientific basis of
clinical toxicology e.g., medicine, pharmacology etc.
3. Total duration for Forensic Medicine and Toxicology
a) Semesters: Total 4 Semesters
b) Teaching hours: 125
c) Phase (II): 50 hours
i. Lectures: 15 hours
ii. Self-Directed learning (SDL): 5 hours
iii. Small group teachings/tutorials/Integrated teaching/Practical: 30 hours
d) Phase (III/I): 75 hours
i. Lectures: 25 hours
ii. Self-Directed learning (SDL): 5 hours
iii. Small group teachings/tutorials/Integrated teaching/Practical: 45 hours
4. Syllabus
4. (a) Learning methods:
Lectures, tutorials, practical demonstrations, Small group teachings, integrated teaching, Self-
Directed learning (SDL), ATECOM
4. (b)Distribution of teaching hours
Didactic lectures should not exceed one third of the time schedule; two third schedule should
include practical, clinicals or/and small group discussions. Learning process should include living
experiences, problem-oriented approach, case studies and community health care activities.
5. Topic wise distribution
1. Total Teaching hours : 50

2. A. Lectures(hours): 15 B. Self-directed learning ( hours ) : 05
C. Clinical Postings (hours): Nil.
D. Small group teachings/tutorials/Integrated teaching/Practical’s (hours): 30
Competency
Nos. Topics & Subtopics- TL Methods
PHASE II
Topic: General Information
FM 1.1 Demonstrate knowledge of basics of Forensic Medicine like
definitions of Forensic medicine, Clinical Forensic Medicine, Forensic
Pathology, State Medicine, Legal Medicine and Medical
Jurisprudence
FM FM1.3 Describe legal procedures including Criminal Procedure Code,
Lecture-01
1.1, 1.3, 1.4 Indian Penal Code, Indian Evidence Act, Civil and Criminal Cases,
Inquest (Police Inquest and Magistrate’s Inquest), Cognizable and
Non-cognizable offences
FM1.4 Describe Courts in India and their powers: Supreme Court,
High Court, Sessions court, Magistrate’s Court, Labour Court, Family
Court, Executive Magistrate Court and Juvenile Justice Board
FM 1.2 FM1.2 Describe history of Forensic Medicine SDL-01
Competency

FM1.5 Describe Court procedures including issue of Summons,
conduct money, types of witnesses, recording of evidence oath,
Lecture-02
FM affirmation, examination in chief, cross examination, re-examination
1.5, 1.6, 1.7, and court questions, recording of evidence & conduct of doctor in
1.8, 1.9 witness box
FM1.6 Describe Offenses in Court including Perjury; Court strictures
vis-a- vis Medical Officer
FM1.7 Describe Dying Declaration & Dying Deposition
FM1.8 Describe the latest decisions/notifications/resolutions/
circulars/standing orders related to medico-legal practice issued by
FM Lecture-03
Courts/Government authorities etc.
1.8, 1.9
F.M1.9 Describe the importance of documentation in medical
practice in regard to medicolegal examinations, Medical Certificates
and medicolegal reports
Small group- 1
Skills in Forensic Medicine & Toxicology
FM teachings/tutorials/
FM14.20 To record and certify dying declaration in a simulated/
14.20 Integrated
supervised environment
teaching/Practical’s
FM 2.29 Demonstrate respect to the directions of courts, while
appearing as witness for recording of evidence under oath or Small group-2
FM affirmation, examination in chief, cross examination, re-examination teachings/tutorials/
2.29, 14.22
and court questions, recording of evidence Integrated
Skills in Forensic Medicine & Toxicology teaching/Practical’s
FM14.22 To give expert medical/ medico-legal evidence in Court of
law
Clinical Forensic Medicine
IDENTIFICATION
FM 3.1 Define and describe Corpus Delicti, establishment of identity
Lecture-04
of living persons including race, Sex, religion, complexion, stature,
age determination using morphology, teeth-eruption, decay, bite
FM marks, bones-ossification centres, medico-legal aspects of age-Part 1
3.1
IDENTIFICATION
FM 3.1 Define and describe Corpus Delicti, establishment of identity
of living persons including race, Sex, religion, complexion, stature, Lecture-05
age determination using morphology, teeth-eruption, decay, bite
marks, bones-ossification centres, medico-legal aspects of age-Part 2
IDENTIFICATION Small group- 3
FM
FM 3.1 age determination using morphology, teeth-eruption, bones- teachings/tutorials/
3.1
ossification centres, medico-legal aspects of age Integrated teaching
Competency
/Practical’s
IDENTIFICATION
FM 3.2 Describe and discuss identification of criminals, unknown
FM
persons, dead bodies from the remains-hairs, fibers, teeth, Lecture-06
3.2
anthropometry, dactylography, foot prints, scars, tattoos, poroscopy
and superimposition
Small group- 4
IDENTIFICATION
FM 3.2 Dactylography, foot prints, scars, tattoos, poroscopy and
3.2 Integrated teaching
superimposition
/Practical’s
Forensic Pathology
FM2.1 Define, describe and discuss death and its types including
FM somatic/clinical/cellular, molecular and brain-death, Cortical Death
Lecture-07
2.1,2.2,2.3 and Brainstem Death
FM2.2 Describe and discuss natural and unnatural deaths
FM2.3 Describe and discuss issues related to sudden natural deaths
Forensic Pathology
FM2.5 Discuss moment of death, modes of death - coma, asphyxia
and syncope
FM FM2.6 Discuss presumption of death and survivorship
2.5, 2.6. 2.7 Lecture-08
FM2.7 Describe and discuss suspended animation
2.8
FM 2.8 Describe and discuss postmortem changes including signs of
death, cooling of body, post-mortem lividity, rigor mortis, cadaveric
spasm, cold stiffening and heat stiffening
Forensic Pathology
FM
FM2.9 Describe putrefaction, mummification, adipocere and Lecture-09
2.9
maceration
FM Forensic Pathology
Lecture-10
2.10 FM2.10 Discuss estimation of time since death
Forensic Pathology
FM2.11 Describe and discuss autopsy procedures including post-
mortem examination, different types of autopsies, aims and
objectives of post-mortem examination
Small group- 5
FM FM2.12 Describe the legal requirements to conduct post-mortem
teachings/tutorials/
2.11, 2.12, examination and procedures to conduct medico-legal post-mortem
Integrated
2.13, 2.14 examination
FM2.13 Describe and discuss obscure autopsy
FM2.14 Describe and discuss examination of clothing, preservation
of viscera on post-mortem examination for chemical analysis and
other medico-legal purposes, post-mortem artefacts
FM Forensic Pathology Small group- 6
2.15, 2.16, FM 2.15 Describe special protocols for conduction of medico-legal teachings/tutorials/
Competency
2.17, 2.18 autopsies in cases of death in custody or following violation of Integrated

human rights as per National Human Rights Commission Guidelines teaching/Practical’s
FM2.16 Describe and discuss examination of mutilated bodies or
fragments, charred bones and bundle of bones.
FM2.17 Describe and discuss exhumation.
FM2.18 Crime Scene Investigation:- Describe and discuss the
objectives of crime scene visit, the duties & responsibilities of
doctors on crime scene and the reconstruction of sequence of
events after crime scene investigation
Forensic Pathology
FM1.10 Select appropriate cause of death in a particular scenario by Small group- 7
FM referring ICD 10 code teachings/tutorials/
1.10 1.11 FM1.11Write a correct cause of death certificate as per ICD 10 Integrated
document teaching/Practical’s
Forensic Pathology
FM 2.19 Investigation of anaesthetic, operative deaths:
FM
Describe and discuss special protocols for conduction of autopsy and Lecture-11
2.19
for collection, preservation and dispatch of related material
evidences
Forensic Pathology
FM 2.30 Have knowledge/awareness of latest
FM
decisions/notifications/ resolutions/circulars/standing orders SDL-2
2.30
related to medico-legal practice issued by Courts/Government
authorities etc
Forensic Pathology
FM 2.33 Demonstrate ability to use local resources whenever
required like in mass disaster situations
Small group- 8
FM FM 2.34 Demonstrate ability to use local resources whenever
2.33, 2.34, required like in mass disaster situations
Integrated
2.35 FM 2.35 Demonstrate professionalism while conducting autopsy in
medicolegal situations, interpretation of findings and making
inference/opinion, collection preservation and dispatch of biological
or trace evidences
Skills in Forensic Medicine & Toxicology Small group- 9
FM FM14.9 Demonstrate examination of & present an opinion after teachings/tutorials/
14.9 examination of skeletal remains in a simulated/ supervised Integrated
environment teaching/Practical’s
Skills in Forensic Medicine & Toxicology Small group- 10
FM FM14.4 Conduct and prepare report of estimation of age of a person teachings/tutorials/
14.4 for medico-legal and other purposes & prepare medico-legal report Integrated
in a simulated/ supervised environment teaching/Practical’s
Competency
Small group- 11
FM14.21 To collect, preserve, seal and dispatch exhibits for DNA-
14.21 Integrated
Finger printing using various formats of different laboratories.
FM Toxicology: General Toxicology
SDL-3
8.1 FM8.1 Describe the history of Toxicology
Toxicology: General Toxicology
FM8.2 Define the terms Toxicology, Forensic Toxicology,
Clinical Toxicology and poison
FM8.3 Describe the various types of poisons, Toxicokinetics, and
Toxicodynamics and diagnosis of poisoning in living and dead
FM FM 8.6 Describe the general symptoms, principles of diagnosis and
8.2, 8.3, 8.6, Lecture-12
management of common poisons encountered in India
8.7, 8.8
FM 8.7 Describe simple Bedside clinic tests to detect poison/drug in
a patient’s body fluids
FM 8.8 Describe basic methodologies in treatment of poisoning:
decontamination, supportive therapy, antidote therapy, procedures
of enhanced elimination
Toxicology: General Toxicology
FM
FM8.4 Describe the Laws in relations to poisons including NDPS Act, SDL-4
8.4
Medico-legal aspects of poisons
Toxicology: General Toxicology Small group-12
FM 8.9 Describe the procedure of intimation of suspicious cases or teachings/tutorials/
FM
actual cases of foul play to the police, maintenance of records, Integrated
8.9
preservation and dispatch of relevant samples for laboratory teaching/Practical’s
analysis.
Toxicology: General Toxicology Small group-13
FM8.10 Describe the general principles of Analytical Toxicology and teachings/tutorials/
FM give a brief description of analytical methods available for Integrated
8.10 toxicological analysis: Chromatography – Thin Layer teaching/Practical’s
Chromatography, Gas Chromatography, Liquid Chromatography and
Atomic Absorption Spectroscopy
Toxicology : Chemical Toxicology
FM9.1 Describe General Principles and basic methodologies in Small group-14
FM treatment of poisoning: decontamination, supportive therapy, teachings/tutorials/
9.1 antidote therapy, procedures of enhanced elimination with regard Integrated
to: Caustics Inorganic – sulphuric, nitric, and hydrochloric acids; teaching/Practical’s
Organic- Carbolic Acid (phenol), Oxalic and acetylsalicylic acids
Toxicology : Chemical Toxicology Small group-15
FM FM9.2 Describe General Principles and basic methodologies in teachings/tutorials/
9.2 treatment of poisoning: decontamination, supportive therapy, Integrated
antidote therapy, procedures of enhanced elimination with regard teaching/Practical’s
Competency
to Phosphorus, Iodine, Barium

Small group-16
FM9.3 Describe General Principles and basic methodologies in
treatment of poisoning: decontamination, supportive therapy,
9.3 Integrated
antidote therapy, procedures of enhanced elimination with regard
to Arsenic, lead, mercury, copper, iron, cadmium and thallium
FM
treatment of poisoning: decontamination, supportive therapy, Lecture-13
9.4
to Ethanol, methanol, ethylene glycol
Toxicology : Chemical Toxicology Small group-17
FM9.4 Describe General Principles and basic methodologies in teachings/tutorials/
FM
treatment of poisoning: decontamination, supportive therapy, Integrated
9.4
antidote therapy, procedures of enhanced elimination with regard teaching/Practical’s
to Ethanol, methanol, ethylene glycol
to Organophosphates, Carbamates, Organochlorines, Pyrethroids, teaching/Practical’s
Paraquat, Aluminium and Zinc phosphide
to Ammonia, carbon monoxide, hydrogen cyanide & derivatives, teaching/Practical’s
methyl isocyanate, tear (riot control) gases
Pharmaceutical Toxicology
FM to: Lecture-14
10.1
i. Antipyretics – Paracetamol, Salicylates
ii. Anti-Infectives (Common antibiotics – an overview)
iii. Neuropsychotoxicology Barbiturates, benzodiazepins
phenytoin, lithium, haloperidol, neuroleptics, tricyclics
Pharmaceutical Toxicology
Small group-20
10.1 Integrated
to:
Competency
iv .N arcotic Analgesics, Anaesthetics, and Muscle Relaxants

v. Cardiovascular Toxicology Cardiotoxic plants – oleander,
odollam, aconite, digitalis
vi.Gastro- Intestinal and Endocrinal Drugs – Insulin
Toxicology : Biotoxicology
FM
FM11.1 Describe features and management of Snake bite, scorpion Lecture-15
11.1
sting, bee and wasp sting and spider bite
Toxicology : Sociomedical Toxicology Small group-21
FM FM12.1 Describe features and management of abuse/poisoning with teachings/tutorials/
12.1 following chemicals: Tobacco, cannabis, amphetamines, cocaine, Integrated
hallucinogens, designer drugs & solvent teaching/Practical’s
Topic: Toxicology : Environmental Toxicology
FM
FM13.1 Describe toxic pollution of environment, its medico-legal SDL-5
13.1
aspects & toxic hazards of occupation and industry
Small group-22
Topic: Toxicology : Environmental Toxicology
FM13.2 Describe medico-legal aspects of poisoning in
13.2 Integrated
Workman’s Compensation Act
Skills in Forensic Medicine & Toxicology Small group-23
FM FM 14.2 Demonstrate the correct technique of clinical examination teachings/tutorials/
14.2 in a suspected case of poisoning & prepare medico-legal report in a Integrated
simulated/ supervised environment teaching/Practical’s
FM FM14.3 Assist and demonstrate the proper technique in collecting, teachings/tutorials/
14.3 preserving and dispatch of the exhibits in a suspected case of Integrated
poisoning, along with clinical examination teaching/Practical’s
FM FM14.6 Demonstrate and interpret medico-legal aspects from teachings/tutorials/
14.6 examination of hair (human & animal) fibre, semen & other Integrated
biological fluids teaching/Practical’s
FM14.7 Demonstrate & identify that a particular stain is blood and teachings/tutorials/
FM
identify the species of its origin Integrated
14.7, 14.8
FM14.8 Demonstrate the correct technique to perform and identify teaching/Practical’s
ABO & RH blood group of a person
Small group- 27
FM14.16 To examine & prepare medico-legal report of drunk person
14.16 Integrated
in a simulated/ supervised environment
Competency

FM14.17 To identify & draw medico-legal inference from common Small group- 28
FM poisons teachings/tutorials/
14.17 e.g. dhatura, castor, cannabis, opium, aconite copper sulphate, Integrated
pesticides compounds, marking nut, oleander, Nux vomica, abrus teaching/Practical’s
seeds, Snakes, capsicum, calotropis, lead compounds & tobacco.
Course Content
Phase III-Part ONE
Theory / Practical
(Based on National Medical Commission, India Competency based Undergraduate
curriculum for the Indian Medical Graduate, 2018. Vol. 1; page nos. 228 -251)
1. Total Teaching hours : 75
2. A. Lectures(hours):25 B. Self-directed learning ( hours ) :5
C. Clinical Postings (hours):
D. Small group teachings/tutorials/Integrated teaching/ Practicals (hours): 45
AETCOM Modules-3.3-Foundation of Communication and
3.4-Confidentiality
Competency
Topics & Subtopics- TL Methods
Nos.
Medical Jurisprudence (Medical Law and ethics)
FM 4.2 Describe the Code of Medical Ethics 2002 conduct,
Etiquette and Ethics in medical practice and unethical practices &
the dichotomy
FM 4.3 Describe the functions and role of Medical Council of
FM India and State Medical Councils
4.2, 4.3, 4.4, Lecture-1
FM 4.4 Describe the Indian Medical Register
4.5, 4.22
FM 4.5 Rights/privileges of a medical practitioner, penal erasure,
infamous conduct, disciplinary Committee, disciplinary
procedures, warning notice and penal erasure
4.22 Explain Oath – Hippocrates, Charaka and Sushruta and
procedure for administration of Oath.
FM FM4.1 Describe Medical Ethics and explain its historical SDL-1
4.1
emergence
Medical Jurisprudence (Medical Law and ethics) Small group- 1
FM4.7 Describe and discuss the ethics related to HIV patients teachings/tutorials/
FM4.8 Describe the Consumer Protection Act-1986 (Medical Integrated teaching/
FM
Indemnity Insurance, Civil Litigations and Compensations), Practical’s
4.7, 4.8, 4.9
Workman’s Compensation Act & ESI Act
FM4.9 Describe the medico - legal issues in relation to family
violence, violation of human rights, NHRC and doctors
FM Medical Jurisprudence (Medical Law and ethics)
4.6, 4.24, FM4.6 Describe the Laws in Relation to medical practice and the Lecture-2
4.28 duties of a medical practitioner towards patients and society
FM4.24 Enumerate rights, privileges and duties of a Registered
Medical Practitioner. Discuss doctor- patient relationship:
professional secrecy and privileged communication
FM4.28 Demonstrate respect to laws relating to medical
practice and Ethical code of conduct prescribed by Medical
Council of India and rules and regulations prescribed by it from
time to time
FM FM4.10 Describe communication between doctors, public and teachings/tutorials/
4.10, 4.11 media Integrated teaching/
FM4.11 Describe and discuss euthanasia Practical’s
Medical Jurisprudence (Medical Law and ethics) Small group-3
FM4.12 Discuss legal and ethical issues in relation to stem cell teachings/tutorials/
FM research Integrated teaching/
4.12, 4.16,
FM4.16 Describe and discuss Bioethics Practical’s
4.17
FM4.17 Describe and discuss ethical Principles: Respect for
autonomy, non- malfeasance, beneficence & justice
FM4.18 Describe and discuss medical negligence including civil
FM
and criminal negligence, contributory negligence, corporate Lecture-3
4.18
negligence, vicarious liability, Res Ipsa Loquitor, prevention of
medical negligence and defenses in medical negligence litigations
FM4.19 Define Consent. Describe different types of consent and
FM
ingredients of informed consent. Describe the rules of consent Lecture-4
4.19
and importance of consent in relation to age, emergency
situation, mental illness and alcohol intoxication
FM4.20 Describe therapeutic privilege,Malingering,
FM Therapeutic Misadventure, Professional Secrecy, Human
Lecture-5
4.20, 4.21 Experimentation
FM4.21 Describe Products liability and Medical Indemnity
Insurance
FM
FM 4.23 Describe the modified Declaration of Geneva and its SDL-2
4.23
relevance
FM4.25 Clinical research & Ethics Discuss human
Small group-4
FM experimentation including clinical trials
4.25, 4.26, FM4.26 Discuss the constitution and functions of ethical
Integrated teaching/
4.27 committees
Practical’s
FM4.27 Describe and discuss Ethical Guidelines for Biomedical
Research on Human Subjects & Animals
Forensic Pathology
FM FM 2.4 Describe salient features of the Organ Transplantation
Lecture-6
2.4 and The Human Organ Transplant (Amendment) Act 2011 and
discuss ethical issues regarding organ donation
Forensic Pathology
Small group-5
FM2.31 Demonstrate ability to work in a team for conduction of
2.31 medico-legal autopsies in cases of death following alleged
negligence medical dowry death, death in custody or following
Practical’s
violation of human rights as per National Human Rights
Commission Guidelines on exhumation
Small group- 6
FM 4.14 Describe & discuss the challenges in managing medico-
4.14 legal cases including development of skills in relationship
management – Human behaviour, communication skills, conflict
Practical’s
resolution techniques
FM Describe the principles of handling pressure – definition, types, teachings/tutorials/
4.15 causes, sources and skills for managing the pressure while dealing Integrated teaching/
with medico-legal cases by the doctor Practical’s
Small group- 8
4.29 FM4.29 Demonstrate ability to communicate appropriately with
media, public and doctors
Practical’s
Small group- 9
4.30 FM4.30 Demonstrate ability to conduct research in pursuance to
guidelines or research ethics
Practical’s
Mechanical injuries and wounds:
FM 3.4 Define injury, assault & hurt. Describe IPC pertaining to
injuries
FM FM 3.3 Define, describe and classify different types of mechanical
3.4, 3.3 Lecture-7
injuries, abrasion, bruise, laceration, stab wound, incised wound,
chop wound, defense wound, self-inflicted/fabricated wounds
and their medico-legal aspects
injuries, abrasion, bruise, laceration, stab wound, incised wound, Lecture-8
3.3
3.3
3.3
Mechanical injuries and wounds: Small group-10
FM FM3.5 Describe accidental, suicidal and homicidal injuries. teachings/tutorials/
3.5 Describe simple, grievous and dangerous injuries. Describe ante- Integrated teaching/
mortem and post-mortem injuries Practical’s
Small group-11
FM3.6 Describe healing of injury and fracture of bones with its
3.6 Integrated teaching/
medico-legal importance
Practical’s
Mechanical injuries and wounds: Small group-12
FM FM3.7 Describe factors influencing infliction of injuries and teachings/tutorials/
3.7 healing, examination and certification of wounds and wound as a Integrated teaching/
cause of death: Primary and Secondary Practical’s
Small group-13
FM3.8Describe and discuss different types of weapons including
dangerous weapons and their examination
Practical’s
Firearm injuries:
FM3.9 Describe different types of firearms including structure
FM and components. Along with description of ammunition
Lecture-11
3.9 propellant charge and mechanism of fire-arms, different types of
cartridges and bullets and various terminology in relation of
firearm – caliber, range, choking
Firearm injuries:
FM3.10 Describe and discuss wound ballistics-different types of
FM firearm injuries, blast injuries and their interpretation,
Lecture-12
3.10 preservation and dispatch of trace evidences in cases of firearm
and blast injuries, various tests related to confirmation of use of
firearms
Firearm injuries:
FM3.10 Describe and discuss wound ballistics-different types of
FM firearm injuries, blast injuries and their interpretation,
Lecture-13
3.10 preservation and dispatch of trace evidences in cases of firearm
and blast injuries, various tests related to confirmation of use of
firearms
Regional Injuries:
FM3.11 Describe and discuss regional injuries to head (Scalp
FM
wounds, fracture skull, intracranial haemorrhages, coup and Lecture-14
3.11
contrecoup injuries), neck, chest, abdomen, limbs, genital organs,
spinal cord and skeleton
Regional Injuries Small group-14
FM3.12 Describe and discuss injuries related to fall from height teachings/tutorials/
FM
3.12 and vehicular injuries – Primary and Secondary impact,
Secondary injuries, crush syndrome, railway spine
Practical’s
FM Forensic Pathology Lecture-15
2.24
FM2.24 Thermal deaths: Describe the clinical features, post-
mortem finding and medicolegal aspects of injuries due to
physical agents like heat (heat-hyper-pyrexia, heat stroke, sun
stroke, heat exhaustion/prostration, heat cramps [miner’s cramp]
or cold (systemic and localized hypothermia, frostbite, trench
foot, immersion foot)
Forensic Pathology
FM FM2.25 Describe types of injuries, clinical features, patho-
2.25 Lecture-16
physiology, post- mortem findings and medico-legal aspects in
cases of burns, scalds, lightening, electrocution and radiations
Forensic Pathology
FM FM 2.26 Describe and discuss clinical features, post-mortem
2.26 SDL-3
findings and medico-legal aspects of death due to starvation and
neglect
Skills in Forensic Medicine and Toxicology Small group-15
FM FM14.1 Examine and prepare Medico-legal report of an injured teachings/tutorials/
14.1 person with different etiologies in a simulated/ supervised Integrated teaching/
environment Practical’s
Skills in Forensic Medicine and Toxicology
Small group-16
FM14.10 Demonstrate ability to identify & prepare medicolegal
inference from specimens obtained from various types of injuries
e.g. contusion, abrasion, laceration, firearm wounds, burns, head
Practical’s
injury and fracture of bone
Skills in Forensic Medicine and Toxicology
FM14.11 To identify & describe weapons of medicolegal
importance which are commonly used e.g. lathi, knife, kripan,
Small group-17
axe, gandasa, gupti, farsha, dagger, bhalla, razor & stick.
Able to prepare report of the weapons brought by police and to
give opinion regarding injuries present on the person as
Practical’s
described in injury report/ PM report so as to connect weapon
with the injuries. (Prepare injury report/ PM report must be
provided to connect the weapon with the injuries)
FM FM14.12 Describe the contents and structure of bullet and teachings/tutorials/
14.12 cartridges used & to provide medico-legal interpretation from Integrated teaching/
these Practical’s
Mechanical asphyxia:
FM2.20 Define, classify and describe asphyxia and
medico-legal interpretation of post-mortem findings in asphyxial
deaths
FM Lecture-17
2.20, 2.21
FM2.21 Describe and discuss different types of hanging and
strangulation including clinical findings, causes of death, post-
mortem findings and medico-legal aspects of death due to
hanging and strangulation including examination, preservation
and dispatch of ligature material
FM2.21 Describe and discuss different types of hanging and
FM strangulation including clinical findings, causes of death, post- Lecture-18
2.21 mortem findings and medico-legal aspects of death due to
hanging and strangulation including examination, preservation
and dispatch of ligature material
FM 2.22 Describe and discuss patho-physiology, clinical features,
FM post- mortem findings and medico-legal aspects of traumatic Lecture-19
2.22
asphyxia, obstruction of nose & mouth, suffocation and sexual
asphyxia
FM FM2.23 Describe and discuss types, patho-physiology, clinical
Lecture-20
2.23 features, post mortem findings and medico-legal aspects of
drowning, diatom test and, gettler test.
SEXUAL OFFENCES
FM3.18 Describe anatomy of male and female genitalia, hymen
and its types. Discuss the medico-legal importance of hymen.
Define virginity, defloration, legitimacy and its medicolegal
FM Lecture-21
3.18, 3.13 importance
FM3.13 Describe different types of sexual offences. Describe
various sections of IPC regarding rape including definition of rape
(Section 375 IPC), Punishment for Rape (Section 376 IPC) and
recent amendments notified till date
SEXUAL OFFENCES
Small group-19
FM3.14 Describe and discuss the examination of the victim of an
alleged case of rape, and the preparation of report, framing the
opinion and preservation and dispatch of trace evidences in such
Practical’s
cases
SEXUAL OFFENCES Small group-20
FM FM3.15 Describe and discuss examination of accused and victim teachings/tutorials/
3.15 of sodomy, preparation of report, framing of opinion, Integrated teaching/
preservation and dispatch of trace evidences in such cases Practical’s
Medical Jurisprudence (Medical Law and ethics) Small group-21
FM FM 4.13 Describe social aspects of Medico-legal cases with teachings/tutorials/
4.13 respect to victims of assault, rape, attempted suicide, homicide,
domestic violence, dowry- related cases Practical’s
FM FM14.14 To examine & prepare report of an alleged accused in teachings/tutorials/
14.14 rape/unnatural sexual offence in a simulated/ supervised Integrated teaching/
environment Practical’s
FM Skills in Forensic Medicine and Toxicology Small group-23
14.15 FM14.15 To examine & prepare medico-legal report of a victim of teachings/tutorials/
sexual offence/unnatural sexual offence in a simulated/ Integrated teaching/
supervised environment Practical’s
SEXUAL OFFENCES
FM FM3.16 Describe and discuss adultery and unnatural sexual teachings/tutorials/
3.16 offences- sodomy, incest, lesbianism, buccal coitus, bestiality, Integrated teaching/
indecent assault and preparation of report, framing the opinion Practical’s
and preservation and dispatch of trace evidences in such cases
SEXUAL OFFENCES
FM FM3.17 Describe and discuss the sexual perversions fetishism,
SDL-4
3.17 transvestism, voyeurism, sadism, necrophagia, masochism,
exhibitionism, frotteurism, Necrophilia
FM SEXUAL OFFENCES
3.19 FM3.19 Discuss the medicolegal aspects of pregnancy and
delivery, signs of pregnancy, precipitate labour superfoetation, Lecture-22
superfecundation and signs of recent and remote delivery in
living and dead
Small group-25
FM SEXUAL OFFENCES teachings/tutorials/
14.13 FM14.13 To estimate the age of foetus by post-mortem Integrated teaching/
examination
Practical’s
Small group-26
FM SEXUAL OFFENCES teachings/tutorials/
3.20 FM 3.20 Discuss disputed paternity and maternity Integrated teaching/
Practical’s
Small group-27
FM 3.21 Discuss Pre-conception and Pre Natal Diagnostic
Techniques (PC&PNDT) - Prohibition of Sex Selection Act 2003
and Domestic Violence Act 2005
Practical’s
SEXUAL OFFENCES
FM 3.22 Define and discuss impotence, sterility, frigidity, sexual
dysfunction, premature ejaculation. Discuss the causes of Small group-28
FM impotence and sterility in male and female teachings/tutorials/
3.22, 3.23 FM 3.23 Discuss Sterilization of male and female, artificial Integrated teaching/
insemination, Test Tube Baby, surrogate mother, hormonal Practical’s
replacement therapy with respect to appropriate national and
state laws
SEXUAL OFFENCES
FM 3.24 Discuss the relative importance of surgical methods of
Small group-29
FM contraception (vasectomy and tubectomy) as methods of
3.24, 3.25, contraception in the National Family Planning Programme
3.26 FM 3.25 Discuss the major results of the National Family Health
Practical’s
Survey
FM 3.26 Discuss the national Guidelines for accreditation,
supervision & regulation of ART Clinics in India
FM 3.27 Define, classify and discuss abortion, methods of

procuring MTP and criminal abortion and complication of
FM abortion. MTP Act 1971
3.27, 3.28 Lecture-23
FM 3.28 Describe evidences of abortion - living and dead, duties
of doctor in cases of abortion, investigations of death due to
criminal abortion
Small group-30
Torture and Human rights
FM3.29 Describe and discuss child abuse and battered baby
syndrome
Practical’s
Torture and Human rights Small group-31
FM FM3.30 Describe and discuss issues relating to torture, teachings/tutorials/
3.30 identification of injuries caused by torture and its sequalae, Integrated teaching/
management of torture survivors Practical’s
Small group-32
Torture and Human rights
FM3.31 Describe and discuss guidelines and Protocols of National
Human Rights Commission regarding torture
Practical’s
FM3.32 Demonstrate the professionalism while preparing Small group-33
FM reports in medicolegal situations, interpretation of findings and teachings/tutorials/
3.32 making inference/opinion, collection preservation and dispatch Integrated teaching/
of biological or trace evidences Practical’s
FM FM3.33 Should be able to demonstrate the professionalism while teachings/tutorials/
3.33 dealing with victims of torture and human right violations, sexual Integrated teaching/
assaults- psychological consultation, rehabilitation Practical’s
Forensic Psychiatry
FM5.1 Classify common mental illnesses including post-traumatic
FM
stress disorder (PTSD) Lecture-24
5.1, 5.2
FM5.2 Define, classify and describe delusions, hallucinations,
illusion, lucid interval and obsessions with exemplification
Forensic Psychiatry
FM FM 5.3 Describe Civil and criminal responsibilities of a mentally ill Lecture-25
5.3, 5.4 person
FM 5.4 Differentiate between true insanity from feigned insanity
Forensic Psychiatry Small group-35
FM
FM5.5 Describe & discuss Delirium tremens teachings/tutorials/
5.5, 5.6
FM5.6 Describe the Indian Mental Health Act, 1987 with special Integrated teaching/
reference to admission, care and discharge of a mentally ill Practical’s
person
Forensic Laboratory investigation in medical legal practice
FM 6.1 Describe different types of specimen and tissues to be
Small group-36
collected both in the living and dead: Body fluids (blood, urine,
semen, faeces saliva), Skin, Nails, tooth pulp, vaginal smear,
viscera, skull, specimen for histo-pathological examination, blood
Practical’s
grouping, HLA Typing and DNA Fingerprinting.
FM Forensic Laboratory investigation in medical legal practice

SDL-5
6.1 Describe Locard’s Exchange Principle
FM 6.1 Describe different types of specimen and tissues to be Small group-37
FM collected both in the living and dead: Body fluids (blood, urine, teachings/tutorials/
6.1 semen, faeces saliva), Skin, Nails, tooth pulp, vaginal smear, Integrated teaching/
viscera, skull, specimen for histo-pathological examination, blood Practical’s
grouping, HLA Typing and DNA Fingerprinting.
Small group-38
FM6.2Describe the methods of sample collection, preservation,
labelling, dispatch, and interpretation of reports
Practical’s
FM6.3 Demonstrate professionalism while sending the biological Small group-39
FM or trace evidences to Forensic Science laboratory, specifying the teachings/tutorials/
6.3 required tests to be carried out, objectives of preservation of Integrated teaching/
evidences sent for examination, personal discussions on Practical’s
interpretation of findings
Emerging technologies in Forensic Medicine
FM7.1 Enumerate the indications and describe the principles and
appropriate use for:
- DNA profiling -
Small group-40
Facial reconstruction
- Polygraph (Lie Detector)
- Narcoanalysis,
Practical’s
- Brain Mapping,
- Digital autopsy,
- Virtual Autopsy,
- Imaging technologies
Emerging technologies in Forensic Medicine
FM7.1 Enumerate the indications and describe the principles and Small group-41
FM appropriate use for: teachings/tutorials/
7.1 - DNA profiling - Integrated teaching/
Facial reconstruction Practical’s
- Polygraph (Lie Detector)
- Narcoanalysis,
- Brain Mapping,
- Digital autopsy,
- Virtual Autopsy,
- Imaging technologies
Small group-42
FM14.21 To collect, preserve, seal and dispatch exhibits for DNA-
Finger printing using various formats of different laboratories.
Practical’s
Small group-43
FM14.18 To examine & prepare medico-legal report of a person
in police, judicial custody or referred by Court of Law and
violation of human rights as requirement of NHRC, who has been
Practical’s
brought for medical examination
FM14.19 To identify & prepare medico-legal inference from Small group-44
FM histo-pathological slides of Myocardial Infarction, pneumonitis, teachings/tutorials/
14.19 tuberculosis, brain infarct, liver cirrhosis, brain haemorrhage, Integrated teaching/
bone fracture, Pulmonary oedema, brain oedema, soot particles, Practical’s
diatoms & wound healing
Small group-45
FM FM14.5 Conduct & prepare post-mortem examination report of
Practical’s
14.5 varied etiologies (at least 15) in a simulated/ supervised
It can be scheduled at
environment
any small groups as
Journal and logbook checking-
per availability of Post
Mortem examination.
MBBS
PHASE II& PHASE III Part -I
Internal Assessment
I-Exam (After 3 months from start of II

II-Exam (After three months of I Interna
Phase-Jan in case phase II started in
assessment Examination- Apr.)
Oct.)
Phase
Practical (Including Practical Including 10
Total Total
Theory 10 Marks for Journal Theory Marks for Journal &
Marks Marks
& Log Book ) Log Book
II
50 40+10=50 100 50 40+10=50 100
MBBS
I-Exam (After 3 months from start of

III Phase- Jan/Feb in case phase III II-Exam ( June/July-Preliminary)
started in Oct.)
Phase
Practical (Including Practical
Total Total
Theory 10 Marks for Journal Theory
Marks Marks
& Log Book )
III/PART-I
50 40+10=50 100 100 100 200
MBBS
1. There will be 4 internal assessment examinations in Forensic medicine. The structure of the Preliminary internal
assessment theory examinations should be similar to the structure of University examination.
2. It is mandatory for the students to appear for all the internal assessment
Examinations in the respective phases. A student who has not taken minimum required number of tests for Internal
Assessment each in theory and practical will not be eligible for University examinations.
3. There will be only one additional examination for absent students (due to genuine reason) after approval by the
Institutional Grievances Committee. It should be taken after preliminary examination and before submission of
internal assessment marks to the University.
4. Internal assessment marks for theory will be out of 250 and practical will be out of 250.
5. Reduce total theory internal assessment to 40 marks and total practical internal assessment to 40 marks. Students
must secure at least 50% marks of the total marks (combined in theory and practical; not less than 40 % marks in
theory and practical separately) to be eligible for appearing University examination
6. Conversion Formula for calculation of marks in internal assessment examinations

First IA Second IA Third IA (Prelim) Total Internal assessment Eligibility to appear for final
II Phase II Phase III Phase III Phase marks: Conversion University examination
Part -I Part -I formula (after conversion out of 40)
(out of 40) (40% separately in Theory & Practical,
50% Combined)
Theory 50 50 50 100 250 Total marks obtained
6.25 16
(Minimum) Total of Theory +
Practical Must be 40.
Practical 50 50 50 100 250 Total marks obtained 16
6.25 (Minimum)
7. While preparing Final Marks of Internal Assessment, the rounding-off marks shall done as illustrated in following
table
Internal Assessment Marks Final rounded marks

15.01 to 15.49 15
15.50 to 15.99 16
8. Students must secure at least 50% marks of the total marks (combined in theory and practical / clinical; not less
than 40 % marks in theory and practical
Separately) assigned for internal assessment in order to be eligible for appearing at the final University examination
of that subject. Internal assessment marks will reflect as separate head of passing at the summative examination.
9. Internal assessment marks will not to be added to marks of the University examinations and will be shown
separately in mark list.
Second & Third part I MBBS Practical Mark’s Structure
Internal Assessment Examinations
INTERNAL ASSESSMENT EXAMINATION-AS PER THE SYLABUS OF THEORY AND PRACTICAL COVERED IN THAT
SPECIFIC DURATION OF PHASE-AUTONOMY AT INSTITUTE LEVEL.
Theory Internal Assessment Pattern

Total marks-50
Section A-MCQ’s-10 Marks
Section-B- Short Answer Questions-30 Marks (6 out 0f 7)-5 Marks Each
Section-C-Long Answer Questions-10 Marks (1 out of 2)-10 Marks each.
Practical Internal Assessment Pattern

Total Marks-50.
Exercises taught in that particular term-30 Marks
(Each Exercise marks should be as per University Exam pattern)
Viva-10 Marks
Journal and Log book-10 marks
Paper wise distribution of topics for Prelim & MUHS Annual Examination
Year: PHASE III,PART I , Subject: Forensic Medicine
Paper Section Topics

Only one Section A MCQs on all topics of the paper I
paper Section B 1Court Procedures
2.Identity
3.Death and it’s changes
4.Toxicology
5. Forensic Laboratory investigation in medical legal
practice
Section C 1.Medical Jurisprudence
2.Injury-Mechanical,regional,thermal,lightning,electrical
etc.
3.Voilent Asphyxial deaths
4.Sexual offences
5.Forensic Psychiatry
6. AETCOM Modules.
II A
Not
applicable
PHASE III PART I-MBBS Practical Mark’s Structure MUHS

Practical Oral/ Viva Total
Spots-
Medical Survivor/  Bone-1
Alcohol Age/
Certificat Accused Sickness/ Forensic Medical Practical
Injury Intoxication Potency/ Weapon  Specimen-1
e of Cause of Sexual Fitness Total Pathology, Clinical Jurisprudence and Total & Oral
report Drunkenness Foetus Report  Poison-2
Seat of Death Assault certificate Forensic Medicine Toxicology (I + L)
report Report  X-ray/ Photograph/
No. (MCCD) report
Instrument/ Document-1
A B C D E F G H I J K L M
Max.
10 10 10 10 10 10 5 3 X 5= 15 80 10 10 20 100
Marks
Suggestions:
1. It is suggested that 2 exercises can be kept as actual case or in simulated environment.
2. In the spots -2 spots can be kept as OSPE stations.
Phase III Part I MBBS Practical Mark’s Structure Preliminary
Examination
Practical Oral/ Viva Total

Spots-
Medical Survivor/  Bone-1
Alcohol Age/
Certificat Accused Sickness/ Forensic Medical Practical
Injury Intoxication Potency/ Weapon  Specimen-1
e of Cause of Sexual Fitness Total Pathology, Clinical Jurisprudence and Total & Oral
report Drunkenness Foetus Report  Poison-2
Seat of Death Assault certificate Forensic Medicine Toxicology (I + L)
report Report  X-ray/ Photograph/
No. (MCCD) report
Instrument/ Document-1
A B C D E F G H I J K L M
Max.
10 10 10 10 10 10 5 3 X 5= 15 80 10 10 20 100
Marks
Suggestions:
1. It is suggested that 2 exercises can be kept as actual case or in simulated environment.
2. In the spots - 2 spots can be kept as -OSPE stations.
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
FORMAT / SKELETON OF QUESTION PAPER
1. Course and : MBBS –PHASE III Part -I 2. Subject Code :

Year
(applicable w.e.f. OCT 2022 & onwards examinations)
3. Subject (PSP) : Forensic Medicine & Toxicology
(TT) :
4. Paper : : -- 5. Total Marks : 100__ 6. Total Time : 3 Hrs. 7. Remu. (Rs) : Rs. 300/-
__ 8. Remu. (Rs) : Rs. 350/-
9. Web Pattern : [ ] 10. Web : [ ] 11. Web : [ ] 12. Web Old QP : [ ]
Skeleton Syllabus
Instructions: SECTION “A” MCQ

1) Put in the appropriate box below the question number once only.
2) Use blue ball point pen only.
3) Each question carries One mark.
4) Students will not be allotted mark if he/she overwrites strikes or put white ink on the cross once
marked.
SECTION “A” MCQ (20 Marks)

1. Multiple Choice Questions (Total 20 MCQ of One mark each) (20 x 1=20)
a) b) c) d) e) f) g) h) i) j)
k) l) m) n) o) p) q) r) s) t)
SECTION “B” & “C”
Instructions: 1) Use blue/black ball point pen only.

2) Do not write anything on the blank portion of the question paper. If written anything, such type of act will be considered as
an attempt to resort to unfair means.
3) All questions are compulsory.
4) The number to the right indicates full marks.
5) Draw diagrams wherever necessary.
6) Distribution of syllabus in Question Paper is only meant to cover entire syllabus within the stipulated frame. The Question
paper pattern is a mere guideline. Questions can be asked from any paper’s syllabus into any question paper. Students cannot
claim that the Question is out of syllabus. As It is only for the placement sake, the distribution has been done.
7) Use a common answer book for all sections.
SECTION “B” ( 40 Marks )

2 Short Answer Questions (Any 6 out of 7) (6x5=30)
.
a) b) c) d) e) f) g)
Long Answer Questions (Any 1 out of 2) (1x10=10)
3
a) . b)
SECTION “C” ( 40Marks)
4 Short answer questions (One short note should be from AETCOM 3.3 and 3.4 is compulsory ) (Any 6 out of 7 ) (6x5=30)
a) b) c) d) e) f) g)
.
5. Long Answer Questions (Any 1 out of 2 ) (1x10=10)
a) b)
Maharashtra University of Health Sciences,
Nashik
FORENSIC MEDICINE AND TOXICOLOGYLOGBOOK for

PHASE II and PHASE III (Part 1) MBBS STUDENTS AS PER
COMPETENCY BASED CURRICULUM
First Edition: 2021
1|Page
Preface
The National Medical Commission has revised the undergraduate medical
education curriculum so that the Indian Medical Graduate (IMG) is able to
recognize “Health for all” as a national goal. He/she should also be able to
fulfil his/her societal obligations. The revised curriculum has specified the
competencies that a student must attain and clearly defined teaching learning
strategies for the same. With this goal in mind, integrated teaching, skill
development, AETCOM and self-directed learning have been introduced. There
would be emphasis on communication skills, basic clinical skills and
professionalism. There is a paradigm shift from the traditional didactic
classroom-based teaching to learning environments where there is emphasis
on learning by exploring, questioning, applying, discussing, analysing,
reflecting, collaborating and doing. The recognition of this need is enshrined by
a greatly enhanced allocation of time to these methods and also the
assessment techniques. With this view in mind the log book has been designed
as per the guidelines of Competency Based Curriculum.
2|Page
Name of the College
________________________________________________________________
________________________________________________________________
Admission Year: ____________
CERTIFICATE
This is to certify that,
Mr/Ms.______________________________________________________
Roll No. ________ has satisfactorily attended/completed all assignments
mentioned in this logbook as per the guidelines prescribed by National
Medical Commission, India for Phase II & Phase III (Part 1) MBBS Competency
Based Curriculum in the subject of FORENSIC MEDICINE & TOXICOLOGY.
Date: ___/___/______
Place: _____________
Teacher In-charge Professor and Head

Department of FORENSIC MEDICINE & TOXICOLOGY
3|Page
Instructions
1) This logbook is prepared as per the guidelines of NMC for implementation of
Competency based curriculum for Phase II MBBS and Phage III Part one
students in the subject of Forensic Medicine & Toxicology.
2) Students are instructed to keep their logbook entries up to date.
3) Students are expected to write minimum 2 reflections on any two activities
each of Clinical Forensic Medicine skills & Self-Directed Learning (SDL).
4) Students also have to write reflections on AETCOM Module - Reflections
should be structured using the following guiding questions:
 What happened? (What did you learn from this experience)
 So what? (What are the applications of this learning)
 What next? (What knowledge or skills do you need to develop so that
you can handle this type of situation?)
5) The logbook assessment will be based on multiple factors like
 Attendance
 Active participation in the sessions
 Timely completions
 Quality of write up of reflections
 Overall presentation
4|Page
INDEX
Status
Signature of
Sr. No Description Page No’s Complete/
Teacher
Incomplete
Clinical Forensic
1
Medicine Skills
Self-Directed
Learning,
2
Seminars, Projects,
Quizzes
3 AETCOM Module
Attendance
4
Records
Records of Internal
5
Assessment
* AETCOM – Competencies for IMG, 2018, Medical Council of India.
5|Page
Record of Clinical Forensic Medicine & Toxicology Skills
Subject: Forensic Medicine & Toxicology Phase II & Phase III part I
MBBS
Sub Item: Practicals (Student Lab.) / Practicals(Forensic Medicine & Toxicology) / Vertical Integration
/ Early Clinical Exposure / Seminar / Self Directed Learning
Competency Name of Date Attempt Rating Decision Initial Feedbac

# addressed Activity completed at Below (B) of faculty of k
: dd- activity expectation Complete facult Received
mmyyyy First or s Meets (M) d (C) y and Initial of
Only (F) expectation Repeat (R) date learne
Repeat s Exceeds Remedial
(R) (E) (Re)
Remedia expectation
l (Re) s OR
Numerical
Score
FM To record and
14.20 certify dying
declaration in a
simulated/
supervised
environment
FM To give expert
14.22 medical/
medico-legal
evidence in
Court of law
FM Demonstrate
14.9 examination of
& present an
opinion after
examination of
skeletal
remains in a
simulated/
supervised
environment
FM Conduct and
14.4 prepare report
of estimation of
age of a person
for medico-
legal and other
purposes &
prepare
medico-legal
report in a
simulated/
supervised
environment
FM Demonstrate the
14.2 correct
6|Page
technique of
clinical
examination in a
suspected case
of poisoning &
prepare medico-
legal report in a
simulated/
supervised
environment
FM Assist and
14.3 demonstrate
the proper
technique in
collecting,
preserving and
dispatch of the
exhibits in a
suspected case
of poisoning,
along with
clinical
examination
FM Demonstrate
14.6 and interpret
medico-legal
aspects from
examination of
hair (human &
animal) fibre,
semen & other
biologicalfluids
FM Demonstrate &
14.7 identify that a
particular stain
is blood and
identify the
species of
itsorigin
FM Demonstrate
14.8 the correct
technique to
perform and
identify ABO
&RH blood
group of
aperson
FM To collect,
14.21 preserve, seal
and dispatch
exhibits for
DNA-Finger
printing using
various formats
of different
laboratories.
FM To examine &
7|Page
14.16 prepare
medico-legal
report of drunk
person in a
simulated/
supervised
environment
FM To identify &
14.17 draw medico-
legal inference
from common
poisons e.g.
dhatura, castor,
cannabis,
opium, aconite
copper
sulphate,
pesticides
compounds,
marking nut,
oleander, Nux
vomica, abrus
seeds, Snakes,
capsicum,
calotropis, lead
compounds &
tobacco.
FM Examine and
14.1 prepare Medico-
legal report of
an injured
person with
different
etiologies in a
simulated/
supervised
environment
FM Conduct &
14.5 prepare post-
mortem
examination
report of varied
etiologies (at
least 15) in a
simulated/
supervised
environment
FM Demonstrate
14.10 ability to identify
& prepare
medicolegal
inference from
specimens
obtained from
various types of
injuries e.g.
contusion,
abrasion,
8|Page
laceration,
firearm wounds,
burns, head
injury and
fracture ofbone
FM To identify &
14.11 describe
weapons of
medicolegal
importance
which are
commonly used
e.g. lathi, knife,
kripan, axe,
gandasa, gupti,
farsha, dagger,
bhalla, razor
&stick.
Able to prepare
report of the
weapons
brought by
police and to
give opinion
regarding
injuries present
on the person as
described in
injury report/
PM report so as
to connect
weapon with the
injuries.
(Prepare injury
report/ PM
report must be
provided to
connect the
weapon with the
injuries)
FM Describe the
14.12 contents and
structure of
bullet and
cartridges used
& to provide
medico-legal
interpretation
from these
FM To estimate the
14.13 age of foetus by
post-mortem
examination
FM To examine &
14.14 prepare report
of an alleged
accused in
9|Page
rape/unnatural
sexual offence
in a simulated/
supervised
environment
FM To examine &
14.15 prepare
medico-legal
report of a
victim of sexual
offence/unnatu
ral sexual
offence in a
simulated/
supervised
environment
FM To examine &
14.18 prepare
medico-legal
report of a
person in
police, judicial
custody or
referred by
Court of Law
and violation of
human rights as
requirement of
NHRC, who has
been brought
for medical
examination
FM To identify &
14.19 prepare
medico-legal
inference from
histo
pathological
slides of
Myocardial
Infarction,
pneumonitis,
tuberculosis,
brain infarct,
liver cirrhosis,
brain
haemorrhage,
bone fracture,
Pulmonary
oedema, brain
oedema, soot
particles,
diatoms &
wound healing
10 | P a g e
Reflection on Clinical FORENSIC MEDICINE Skills
Name of the session:
Name of the faculty member/ presenter:
Date: Time: Duration:
Specific learning objectives of the session:
1)
2)
3)
Teaching Learning Methods:

Signature of Teacher-in- charge
11 | P a g e
1)
2)
3)

12 | P a g e
1)
2)
3)

13 | P a g e
2. Self-Directed Learning (SDL), Seminars, Tutorials, Projects,
Quizzes
Self-Directed Learning,
Signature of
Sr.No Seminars, Tutorials, Date
Teacher
Projects, Quizzes
14 | P a g e
Reflection on Self- Directed Learning (SDL) activities
1)
2)
3)

15 | P a g e
1)
2)
3)

16 | P a g e
1)
2)
3)

17 | P a g e
3: AETCOM Module
18 | P a g e
Reflection on AETCOM module
1)
2)
3)

19 | P a g e
1)
2)
3)

20 | P a g e
1)
2)
3)

21 | P a g e
4A: Attendance Record of the Student
Theory Practical Signature of Signature of

Sr. No Phase
(%) (%) the Student the Teacher
A Phase II
B Phase III – Part - I
C OVER ALL
ATTENDANCE
Note: Above information is for the benefit of students and parents. In case of any
discrepancy departmental record will be treated as final.
22 | P a g e
SECTION 4B: Details of attending extra classes [For poor attendance
(if any)]
Signature of Signature of
Sr.No Date Period Total hrs
student Teacher
Total hours
23 | P a g e
Section 5. Records of Internal Assessment Examinations
Records of Internal Assessment examinations
Practical
Signature of Signature of
Sr.No Exam Theory including
student Teacher
viva
I Internal
1 / 50 / 50
Assessment
II Internal
2 / 50 / 50
Assessment
III Internal
3 / 50 / 50
Assessment
IV Internal
4 Assessment /100 /100
(Prelim)
Internal
4 Assessment / 250 / 250
marks
Betterment
5 / 100 / 100
exam
Final
6 Internal / 250 / 250
Assessment
Final
Internal
7 Assessment
(After
Conversion)
24 | P a g e
Maharashtra University of Health
Sciences, Nashik
Practical Journal
Forensic Medicine and Toxicology
Name of Institute: _______________________________________

______________________________________________________
University Roll No: ___________________________
Name of Student: _______________________________________

Roll No: __________ Batch: ________________
Session From: ____________________to____________________
(i)
(ii)
CERTIFICATE
Certified that this is the Bonafide Record of the practical work done by
Mr. / Miss ______________________________________________________
in the Department of Forensic Medicine and Toxicology, __________________
_______________________________________________________________
during the session from ____________________ to ___________________ and
his / her work is satisfactory / not satisfactory.
University Roll No. _______________________________
Signature of In-charge with

Phase Remark
Date
Phase II
Phase III –
Part I
In-charge Practical Programme Professor & Head
Sign/s of University Examiner/s & Date

(iii)
(iv)
Code of Medical Ethics
1. I solemnly pledge myself to consecrate my life to the service of humanity.
2. Even under threat, I will not use my medical knowledge contrary to the laws
of humanity.
3. I will maintain the utmost respect for human life from the time of conception.
4. I will not permit consideration of religion, nationality, race, party politics or

social standing to intervene between my duty and my patient.
5. I will practice my profession with conscience and dignity.
6. The health of my patient is my first consideration.
7. I will respect the secrets, which are confided in me.
8. I will give my teachers the respect and gratitude, which is their due.
9. I will maintain in my power, the honour and the noble tradition of medical
profession.
10. My colleagues will be my brothers.
I make these promises solemnly, freely and upon my honour.
Signature
Place: - Name __________________________

Seal: - Address _________________________
________________________________
(v)
INDEX
Part- I Medico-legal and Medical Certificates
Sr.
Certificates Page Remark Sign
No.
Examination of skeletal remains
1 2
(bones) for medicolegal purpose
2 Age Estimation Report 12
3 Examination of Foetus for Age 20
4 Medical Certificate of Cause of Death 24

Medical Sickness / Under Treatment
5 32
Certificate
6 Medical Fitness Certificate 34
7 Fitness Certificate for Employment 36

Examination \ Certificate of the injured
8 38
(Injury Report)
9 Examination of Weapon 44
Medico-legal Examination of Survivors
10 52
/ Victims of Sexual Violence
Examination of Accused of Sexual
11 62
Violence
12 Potency Certificate 66
Examination of Alcoholic Person
13 70
(Drunkenness)
Medico-Legal Examination of person
14 82
in Police / Judicial Custody
Part- II Medico-legal Articles

Sr.
Articles of Medico-legal Importance Page Remark Sign
No.
1 Photographs 88
2 Museum Specimens 100
3 Instruments 104
4 X-Rays 108
5 Poisons 115
(vi)
Part- III Medico-legal Autopsy
Sr. P.M. No./ Year
Cause of Death Sign
No. Date
/
1
pg.153
/
2
pg.157
/
3
pg.161
/
4
pg.165
/
5
pg.169
/
6
pg.173
/
7
pg.177
/
8
pg.181
/
9
pg.185
/
10
pg.189
Part- IV Common Medico-legal proforma routinely used in medico-legal Practice

Sr.
Medico-legal Proforma Page Remark Sign
No.
Form used when forwarding
1 195
Viscera to the Chemical Analyser
Forms used when forwarding substance
2 199
other than viscera to the chemical analyser
Form for Dispatch of Viscera for
3 201
Histopathological Examination
4 Labels for Viscera Bottles 202
Identification form for forwarding samples
5 203
for DNA Fingerprinting
6 Summon to witness 205
(vii)
Instructions to the students for Practical work
1. Punctuality in attending practical classes should be maintained, as

80 % attendance in practical is mandatory to appear for university
examinations.
2. Silence and discipline should be observed during practical work.
3. Clean apron should be worn before entering the practical hall.
4. Every student should bring the practical record, a piece of clean linen, a
measuring tape, stethoscope, torch, hammer and a hand lens and coloured
pencils.
5. Listen carefully to the instructions given by the teacher for the day’s
work.
6. After finishing the practical work, complete them in the record book, get
the record checked by the teacher on the same day.
(viii)
Part- I
Medico-legal and Medical Certificates
-1-
01. Examination of Skeletal Remains (Bones) For Medicolegal Purpose
1) List of Bones received ( Name of Bone ):--

a. Gross anatomical characteristic
2) Condition of Bone: --
Brittle, Soiled, Stained, Damaged, Partly Burnt
3) Human or not: --
a. Gross anatomical characteristic b. Microscopic examination,
c. Chemical analysis of bone ash d. Precipitin test or Antihuman Immunoglobulin
4) Belong to one individual or more?
a. Number, side and size of the bones b. Age and Sex
c. Morphological similarities d. Use of short wave ultra violet light
e. X-ray comparison or trabecular pattern f. Neutron activation analysis
5) Stature: --(body Height/ length)
a. Use of multiplication Factor/Regression equation
6) Race of Individual: --
a. Racial peculiarities in the individual bones (various indices)
7) Age of Individual: -
a. Dental status if skull or mandible is available b. Ossification status
c. Secondary changes in the bones like closure of skull sutures, bony joint surface etc
8) Sex of Individual: --
a. General Characteristic b. Specific Changes in the individual bone
c. Examination of soft parts if available
9) Injuries:
Ante mortem or Post-mortem or Could not be determined
10) Manner of Separation: -

a. State of soft tissue if available with marks of bite/cut etc.
b. Changes due to putrefaction
11) Cause of Death: -
a. Any injuries/ fracture b. Foreign body –bullet, pellets or any piece of weapon
c. Chemical analysis for poisoning d. Neutron activation analysis
12) Time since Death: -
a. State of soft tissue if available b. Changes due to putrefaction
c. Immunological test d. Precipitin test
e. Nitrogen content test.
13) Identification of Subject: -
a. Congenital abnormalities or deformities
b. Acquired peculiarities –injuries fractures etc.
c. Determination of the blood group from the marrow/ tooth pulp
d. Age, sex/ Race and stature of the individual
e. Radiological examination.
-2-
Examination of Skeletal Remains (Bones) For Medicolegal Purpose
To,
The Investigating Officer
__________________Police Station____________
Subject: - Regarding Examination of Bones (Skeletal remains)

Reference: Your letter No.______________ Dated_________ received on Date________
ADR No/ C.R. No._______ u/s____________________________________
Here with forwarding opinion regarding Skeletal remains Brought by PC____________B.No.______
______________________Police Station___________________.
Bones / Skeletal remains received in sealed /not sealed condition. Seal verified and found intact.
Observation / Examination Finding
1) List of Bones received: --( Name of Bone )
(Brittle, Soiled, Stained, Damaged, Intact)
3) Human or not: --
5) Stature: -- (Multiplication factor/Regressive equation)
6) Race: --
7) Age: - A) Ossification Status
B) Secondary Changes
C) Dental Status (Skull, Mandible, Face)
8) Sex: -- A) General Characteristic
B) Specific Changes
9) Injuries: --
10) Manner of Separation:-
Opinion: -
i) From the above finding, I am of opinion that the bone(s) belong to __________________________
origin of ___________________Sex and aged about_____________________________________
ii.) Cause of death _________________________________________________________________
iii) Time since death ________________________________________________________________
Signature
Place:- Name of Doctor ____________________
Seal:- Designation _____________________
-3-
Examination of Skeletal Remains (Bones) For Medicolegal Purpose
To,
__________________Police Station____________
Subject: - Regarding Examination of Bones (Skeletal remains)

Reference: Your letter No.______________ Dated_________ received on Date________
ADR No/ C.R. No._______ u/s____________________________________
Here with forwarding opinion regarding Skeletal remains Brought by PC____________B.No.______
______________________Police Station___________________.
Bones / Skeletal remains received in sealed /not sealed condition. Seal verified and found intact.
Observation / Examination Finding
1) List of Bones received: --( Name of Bone )
(Brittle, Soiled, Stained, Damaged, Intact)
3) Human or not: --
5) Stature: -- (Multiplication factor/Regressive equation)
6) Race: --
7) Age: - A) Ossification Status
B) Secondary Changes
C) Dental Status (Skull, Mandible, Face)
8) Sex: -- A) General Characteristic
B) Specific Changes
9) Injuries: --
10) Manner of Separation: -
Opinion: -
i) From the above finding, I am of opinion that the bone(s) belong to __________________________
origin of ___________________Sex and aged about_____________________________________
ii.) Cause of death _________________________________________________________________
iii) Time since death ________________________________________________________________
Signature
Place:- Name of Doctor ____________________
Seal:- Designation _____________________
-4-
-5-
-6-
-7-
-8-
-9-
- 10 -
- 11 -
02. Age Estimation Report
Dental eruption and age-
Temporary Teeth Eruption Time Permanent Teeth Eruption Time

Central incisors (Lower) 6-8 months First molars 6-7 years
Central incisors (Upper) 7-9 months Central incisors 6-8 years
Lateral incisors (Upper) 7-9 months Lateral incisors 8-9 years
Lateral incisors (Lower) 10-12 months First Bicuspid 9-11 years
first molars 12-14 months Second Bicuspid 10-12 years
Canines 17-18 months Canines 11-12 years
Second molars 20-30 months Second molars 12-14 years
Third molars 17-25 years
Development of hairs-
A) Axillary hair –
• 14 - 15 years : Brownish, soft space growth
• 16 –17 years : Thick, black, well grown
B) Beard and moustaches –
• 15 – 16 years – Begins to appear as downy, brown hair over chin.
Moustaches appear earlier than beard.
1-2 year after eruption hair became blackish and thick.
C) Pubic hairs –
• Stage I – Few brownish, downy hair (12-14 years)
• Stage II – darken and more curled pubic hair (14-16 years)
• Stage III - Darker, thicker, curly adult hair but no hair over medial surface of thigh (16-18 years)
• Stage IV – Thick, black curly pubic hair spread both over Mons pubis and medial surface of
thighs (>18 years)
Ossification centres-
Joint Bone Appearance of Ossification centres Fusion of ossification centres
Lower end- Capitulum-1 year
Trochlea- 10 yrs Lower end of humerus
Humerus
Lateral epicondyle- 11 yrs complete fusion- 14 to 16 yrs
Elbow
Medial epicondyle- 6 to 7 yrs
Radius Upper end (head) - 5 yrs 16 yrs
Ulna Upper end (Olecranon)- 9 yrs 16 yrs
Radius Lower end- 2 yrs 18-19 yrs
Ulna Lower end- 6 yrs 17-18 yrs
Wrist
Pisiform-11 yrs,
Carpals Base of first metacarpal- 15 yrs
Trapezoid, Scaphoid-5yrs
Tri-radiate
Separate centre in acetabulum-13 yrs Fuses in acetabulum- 15 yrs
cartilage
Ischio-Pubic
--- Unites with each other- 6 yrs
rami
Pelvis
Head and
Femur Lesser trochanter – 12 to 14 yrs
both trochanters-17-18 yrs
Iliac crest- 14 yrs 20-21 yrs
Ischial tuberosity- 16 yrs 20-21 yrs
- 12 -
Tanner staging- sexual maturity
MALE (Genital development)
Stage 1: Pre-adolescent stage. Testis, penis, scrotum about same size as childhood. No pubic hair.
Stage 2: Enlargement of scrotum and testis. Skin of scrotum reddens and changes in texture. Scanty
light pubic hair mainly at base of penis. Little enlargement of penis.
Stage 3: Further growth of scrotum. Pubic hair darkens and begins to curl. Penis enlarges mainly in
length.
Stage 4: Increase in breadth of penis. Development of glans. Scrotum enlarges and darkens. Adult
type of pubic hair but does not spread to medial part of thigh.
Stage 5: Genitalia adult type. (Penis-10-12cm, Volume of testis-20cc, length of testis-4cm or more)
Pubic hair spreads to medial part of thigh.
FEMALE (Breast / Pubic hair development)
Stage1: Preadolescent; breast shows elevation of papilla only. No pubic hair
Stage2: Breast bud stage. Elevation of breast and papilla as a small mound. Enlargement of areola
diameter. Scanty lightly pigmented pubic hair, mainly at labia.
Stage3: Further enlargement of breast and areola, no separation at contours. Pubic hair becomes
darker and begins to curl.
Stage4: Projection of areola and papilla to form a secondary mound above the level of breast. Adult
type of pubic hair less in amount and no spread to medial surface of thigh.
Stage5: Mature stage. Projection of nipple only; recession of areola to the level of general contour of
breast. Adult feminine triangular type of pubic hair, may spread to medial side of thigh.
- 13 -
Age Estimation Report
A. Preliminary Information- Name: Shri/ Smt/ Kum. ___________________________________________
Age as stated- _____________ Sex- ______ Address- _________________________________________
Brought by: ______________________________________________________________________________
Date: ______________ Time: _________ MLC No: ______________ Dated: _____________________
Consent: I am willing to get examined physically and radiologically for estimation of age.
(This consent is explained to patient in ___________ language)
Signature/Thumb impression
Examined in presence of- (Subject/Guardian)
Identification Marks:
1. ___________________________________________________________________________
___________________________________________________________________________
2. ___________________________________________________________________________
___________________________________________________________________________
B. Clinical Examination:
Physical development ___________________________ Height_________ Weight ___________
Secondary Sexual Characters:
Male moustaches Female Breast development ___________________
Beard Menarche __________________________________
Voice___________________________________ Last Menstrual period (LMP)__________________
Axillary hair___________________________ Axillary hair _______________________________
Pubic hair Pubic hair __________________________________
External genitalia External genitalia____________________________
C. Dental status-
Spacing behind second molar- _____________ Abnormality if any-_______________________________
D. Radiological Examination: Reference: x-ray plate no._______________________ Date- ___________

1.
2.
3.
4.
Conclusion: From clinical, dental and radiological examinations, the age of the subject on date _______
is between _____________________ to_____________________ including margins of errors.
Date: - Seal Signature

Place: - Name of Doctor ____________________
Designation _____________________
- 14 -
- 15 -
Age Estimation Report
A. Preliminary Information- Name: Shri/ Smt/ Kum. ___________________________________________
Age as stated- _____________ Sex- ______ Address- _________________________________________
Brought by: ______________________________________________________________________________
Date: ______________ Time: _________ MLC No: ______________ Dated: _____________________
Consent: I am willing to get examined physically and radiologically for estimation of age.
(This consent is explained to patient in ___________ language)
Signature/Thumb impression-
1. ___________________________________________________________________________
___________________________________________________________________________
2. ___________________________________________________________________________
___________________________________________________________________________
B. Clinical Examination:
Physical development ___________________________ Height_________ Weight ___________
Secondary Sexual Characters:
Male moustaches Female Breast development ___________________
Beard Menarche __________________________________
Voice___________________________________ Last Menstrual period (LMP)__________________
Axillary hair___________________________ Axillary hair _______________________________
Pubic hair Pubic hair __________________________________
External genitalia External genitalia____________________________
C. Dental status-
Spacing behind second molar- _____________ Abnormality if any-_______________________________
D. Radiological Examination: Reference: x-ray plate no._______________________ Date- ___________

1.
2.
3.
4.
Conclusion: From clinical, dental and radiological examinations, the age of the subject on date _______
is between ____________________ to____________________ including margins of errors.

Designation _____________________
- 16 -
- 17 -
- 18 -
- 19 -
03. Examination of Foetus for Age
To
____________________ Police Station ____________________
Subject: Submission of Report of Examination of Foetus for Age.
Reference: Your letter No.______ ______ Dated _____ _____ ______
Sir,
I am sending to you the Report of Examination of Foetus for Age.
Observations-
I. External Examination:
1. Length:
2. Weight:
3. Lanugo:
4. Scalp Hair:
5. Eyes:
6. Pupillary Membrane:
7. Nails:
8. Vernix Caseosa:
9. Umbilicus:
position & status
10. Genitalia:
11. Any other finding:
II. Internal Examination:
1. Ossification centres:
2. Meconium:
3. Any other findings:
Opinion about the age of foetus: _____________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Place: Signature
Date and Time: Name of Doctor ____________________
Designation _______________________
Receipt: Received original copy of the report, the new-born,

_________________________________ & its belongings. Name & Signature of I.O.
- 20 -
Table: Age-related Changes in the Foetus
Age in Lunar Months

Parameter
3rd 4th 5th 6th 7th 8th 9th 10th
About 45-50
About 9 About 16 About 25 About 30 About 35 About 40 About 45
Length cm
cm cm cm cm cm cm cm
About About About About About About 2- About 3-
Weight About 1kg
30gm 120gm 400gm 700gm 1.5kg 2.5kg 3.5kg
Beyond tips
Thicker
In of fingers
Nearing but do not Reach Beyond
membra- but reach
Nails - tips - reach tips tips of
nous only the
of fingers ends of of fingers fingers
form tips of toes
fingers
First
Greatest Dis-
exhibited Covers Around
between appeared
Lanugo - between face - shoulders -
28 and from the
13 and and body only
30 weeks face
16 weeks
About About About
About
Scalp Hair - - Appear Appreciable 1.0 cm 1.5 cm 2 cm
2-3 cm long
long long long
Indisting Differen-
Sex - - - - - -
uishable tiable
Eyelids
Eyelids
non–
adherent. Well–
Eyes - - - adherent. - -
Eyelashes Formed
Eyelashes
Appear
Present
Pupil
Membrane Appears Visible Present Present Disappears - - -
Present
over
Present over
flexures
Vernix flexures of
- - Appears Present - - of
Caseosa joints and
joints
neck folds
and neck
folds
In the In the
In the In the
upper upper part
beginning whole In the
Meconium - part of of large - -
of large of large Rectum
small intestine
intestine intestine
intestine
Lt—near
Lt—in
the
the
external
scrotum Both
Lie close to inguinal
Rt—near testicles
Testicles - - - respective ring; Rt—
the in the
kidneys near the
external scrotum
internal
inguinal
inguinal
ring
ring
For
For For talus, For
manubrium For cuboid
Centres of calcaneum 2nd & 3rd lower
- - & 1st - upper end
ossification and segment of end of
segment of of tibia, etc.
ischium sternum femur
sternum
- 21 -
- 22 -
- 23 -
04. Medical Certificate of Cause of Death (MCCD)
The data on cause of death contained in the certificate serve many purposes: they help in assessing the
effectiveness of public health programmes and provide a feed-back for future policy and
implementation. They are essential for better health planning and management and for deciding
priorities of health and medical research programmes.
❖ Legal Provisions: Registration of Birth & Deaths Act (RBD), 1969 for certification by a medical
practitioner who has attended the deceased during the latter’s last illness. The relevant sections of
the Act are: Section 10(2), Section 10(3), Section 17(1) (b)
2. SPECIFIC INSTRUCTIONS
2.1 Name of the deceased
To be given in full. Do not use initials. Also give name of father (or husband in case of married
female) after the name of the deceased, using appellation S/o or D/o or W/o. In case of infants not
yet named, write son (or daughter) of, followed by names of mother and father.
2.2 Age
If more than a year old, give age in years last birthday (completed number of years). If under one
year, give age in months and days. If under 24 hours, give in hours and minutes. 2.3 Method of
certification of cause of death 2.3.1 The medical part of the certificate is designed by the WHO to
facilitate reporting the underlying cause of death and to obtain information of the causal and
pathological sequence of events leading to death. It consists of two parts, the first relating to the
sequence of events leading to death, and the second to other significant conditions that contributed
to the death.
2.3.2 This part should be written by the attending physician or a physician having personal
knowledge of the case history. The names of the diseases should be written in full and legibly to
avoid the risk of their being misread. Abbreviations and short form of disease condition should not
be used. He should avoid indefinite or inadequate terms. Inadequate descriptions may put the
statistical office in difficulty at the time of classification of the data. Mention of terminal events or
mode of dying as the only entry in the statement leaves the certificate incomplete. Similarly,
symptomatic remarks will not suffice. A properly completed certificate will show the underlying
cause on the lowest used line of part I and the conditions if any, as a consequence thereof will have
been entered above it in ascending casual order of sequence.
2.3.3 PART – I OF THE CAUSE OF DEATH STATEMENT
Only one cause is to be entered on each line of Part I. The underlying cause of death should be
entered on the lowest line used in this part. The underlying cause of death is the condition that
started the sequence of events between normal health and the (direct) immediate cause of death.
Line (a): Immediate cause
The direct or immediate cause of death is reported on line (a). This is the disease, injury or
complication that directly preceded death. It can be the sole entry in the statement if only one
condition was present at death. There must always be an entry on line (a). The mode of dying (e.g.,
heart failure, respiratory failure) should not be stated at all since it is no more than a symptom of
the fact that death occurred and provides no useful information. In the case of a violent death, enter
the result of the external cause (e.g., fracture of vault or skull, crushed chest).
- 24 -
Line (b): Due to (or as a consequence of) If the condition on line (a) was the consequence of
another condition, record that in line (b). This condition must be antecedent to the immediate cause
of death, both with respect to time and etiological or pathological violence or circumstances of
accident is antecedent to an injury entered on line (a) and should be entered on line (b), although
the two events are almost simultaneous (e.g., automobile accident, fall from tree). An antecedent
condition might have just prepared the way for the immediate cause of death, by damage to tissues
or impairment of function, even after a long interval.
Line (c): The condition, if any which gave rise to the antecedent condition on line (b) is to be
reported here. The remarks given for line (b) apply here also. If the condition on line (b) is the
underlying cause, nothing more be entered on this line. However, if the sequence of events
comprises more than three stages, extra line (and entries) may be made in part I. However, many
conditions are involved; write the full sequence, one condition per line, with the most recent
condition (immediate cause) at the top, and the earliest (the condition that started the sequence of
event between normal health and death) last. Normally the condition or circumstance on the lowest
line used in part I will be taken as the basis for underlying cause statistics, though classification of
it may be modified to take account of complications or other conditions entered by special
provisions of the ICD.
2.3.4 PART-II OTHER SIGNIFICANT CONDITIONS
Enter, in order of significance, all other diseases or conditions believed to have unfavourably
influenced the course of the morbid process and thus contributed to the total outcome but which
were not related to the disease or condition directly causing death. There will be cases where it will
be difficult to decide whether a condition relevant to death should be recorded as part of the fatal
sequence in part I or as a contributory condition in part II. Conditions in part I should represent a
distinct sequence so that each condition may be regarded as being the consequence of the condition
entered immediately below it. Where a condition does not seem to fit into such a sequence, consider
whether it belongs to part II. In certifying the causes of death for Part II, any disease, abnormality,
injury or late effects of poisoning, believed to have adversely affected the decedent should be
reported, including: • Use of alcohol and/or other substances. • Smoking history. • Environmental
factors, such as exposure to toxic fumes, history of working in some specific industry, professional
exposure to toxins, specific animals etc. • Recent pregnancy, if believed to have contributed to the
death. • Late effects of injury, including head injury sequelae • Surgical information, if applicable.
• Any iatrogenic underlying cause.
2.3.5 INTERVAL BETWEEN ONSET AND DEATH
Space is provided, against each condition recorded on the certificate for the interval between the
presumed onset of morbid condition and the date of death. Exact period should be written when it
is known; in other cases, approximate periods like “from birth”, “several years” or “unknown”
should be indicated. This provides a useful check on the sequence of causes as well as useful
information about the duration of illness in certain diseases.
2.4 Accidents or suicide or homicide is ruled out, how the fatal injury occurred should be explained
indicating briefly the circumstances or cause of the accident. In case of medico-legal cases, the
certificate has to be given by the police authorities. However, the Registrar should be informed of
such cases, by the hospital.
- 25 -
2.5 Female death Information on pregnancy and delivery is needed in case of death of women in
the childbearing age (15 to 49 years) even though the pregnancy may have had nothing to do with
the death. 2.6 Ensuring completeness of information
2.6.1 While giving the casual chain of events in the statement of cause of death, a complete case
history is not required but, if information is available, enough details may be given to enable proper
classification of the underlying cause. The certifier cannot always be certain as to what details are
required and therefore, a list giving examples of incomplete descriptions and what additional
information are required is included in the annexure for guidance.
The terms included in the annexure are those employed usually and are of the following types: - (i)
A symptom that may arise from different group of diseases. (ii) A morbid condition that could
result from several types of infection, known or unknown. (iii) With connotation of any of several
morbid conditions having distinctive categories in the classification list like acute, sub-acute,
chronic, simple etc. (iv) Mention of a disease which is generally localised, without indicating the
organ or part of the body affected. (v) A morbid condition that requires for its classification, a
knowledge of the circumstances in which it arose.
2.6.2 As a general rule, record diagnoses as precisely as the information permits, incorporating
relevant details from histological or autopsy reports. Where an important detail is unknown the fact
should be stated.
2.6.3 The following gives the pertinent details required to be spelt out in the medical part of the
certificate corresponding to the major cause group of mortality;
1. Infections: Acute, sub-acute or chronic, name of the disease and/or infecting organism, the site if
localised; mode of transmission, where relevant.
2. Neoplasms: The morphological type if known; malignant, benign etc., site of origin of primary
growth and sites of secondary growths.
3. Endocrine disorders: Nature of disease process or disturbance of function: For thyroid diseases,
whether toxic: for diabetes, nature of complication or manifestation in particular site.
4. Nutritional disorders: Type of deficiency, etc., and severity.
5. Blood disorders: Nature of disease process; type and nature of any deficiency for anaemias;
whether hereditary (where relevant)
6. Nervous system disorders: Disease process; infecting organism (where relevant) whether
hereditary (where relevant).
7. Circulatory diseases: Nature of disease process; site, if localized; acute or chronic where relevant,
specify rheumatic or other aetiology for valvular heart conditions; any complications.
8. Respiratory diseased: Nature of disease process; acute or chronic; infecting organism, any external
cause.
9. Digestive diseased: Nature of disease process; site of ulcers, hernias, diverticula, etc. Acute or
chronic where relevant, nature of any complication for ulcers, appendicitis, hernias.
10. Genitourinary disorders: Acute or chronic, clinical syndrome and pathological lesions; site of
calculi, infecting organism and site of infections; nature of complications.
11. Maternal deaths: Nature of complication: whether obstruction occurred during labour; timing of
death in relation to delivery; for abortions, whether spontaneous or induced, legal or illegal, if
induced.
12. Musculoskeletal disorders: Nature of disease process, infecting organism, underlying systemic
diseases (where relevant); site; complication, whether congenital or acquired for deformities.
13. Congenital anomalies: Site and type, complications.
- 26 -
14. Perinatal deaths: Condition in foetus or infant; conditions in mother or of placenta, cord or
membranes, if believed to have affected the foetus or infant; for deaths associated with immaturity,
state length of gestation and/or birth weight; type of birth trauma; and complications, etc.
15. Injuries: Type, site, complications.
16. Poisoning: Substance involved; whether accidental (if suicide or homicide is ruled out). 17.
Adverse effects of drugs in therapeutic use: State this fact and name or drug, nature of adverse
effect, complications; condition treated.
17. External cause of accidents: For transport accidents, state vehicle involved, whether deceased was
driver, passenger, etc. Description of accident place of occurrence, for other accidents, specifies
circumstances and place of occurrence.
18. Old age or senility: This should not be given if a more specific cause is known. If old age was a
contributory factor it should be entered in part II only.
ICD classification of diseases
The International Classification of Diseases (ICD) is the standard classification system for
epidemiology, health management and clinical purposes. It contains a finite number of mutually
exclusive code categories, describing all disease conditions. The classification is hierarchical in
structure with subdivisions to identify broad groups and specific entities.
There are 3 key elements to the structure of ICD-10:
1. It has 3 volumes
i. Volume 1 -- a tabular listing of diseases
ii. Volume 2 -- an instruction manual
iii. Volume 3 -- the comprehensive alphabetical index of diseases
2. It has 22 chapters
3. The structure of the ICD code is alphanumeric
Filling ICD code on a death certificate
The ICD code should be coded for all causes of death (immediate, intermediate and underlying
causes) on a death certificate. ICD code for each cause of death should be filled against the particular
cause of death in the death certificate.
Example: Patient XYZ is admitted with Acute Gastroenteritis and Dehydration & then dies in the ward.
- 27 -
ANNEXURE-II
For Hospital Events
FORM NO. 4
(See Rule 7)
MEDICAL CERTIFICATE OF CAUSE OF DEATH

(Hospital In-patients. Not to be used for still births)
To be sent to Registrar along with Form No. 2 (Death Report)
Name of the Hospital ___________________________________________________________________

I hereby certify that the person whose particulars are given below died in the hospital in
Ward No._______ On______________ At ___________ AM/PM.
Name of the deceased For use of

statistical
Sex Age at death purpose
If 1 year or If less than 1 If less than one month, If less than one day,
more, age in year, age in age in days age in hours
years month
1, Male
2.Female
Interval between
CAUSE OF DEATH onset and death
approx.
I. Immediate cause: a) ……………………………..…

State the disease, injury or due to (or as a consequence of)
complication
which caused death, not the
mode of dying
such as heart failure, asthenia, etc.
Antecedent cause: b) …………………………………

Morbid conditions, if any, due to (or as a consequence of)
giving rise to the above cause,
stating the underlying conditions last.
II. Other significant conditions c) …………………………

contributing to the death, but not
related to the diseases ……………………………
or conditions causing it.
……………………………
Manner of Death How did the injury occur?

1. Disease 2. Accident 3. Assault 4. Intentional self-harm 5. Legal intervention 6. War
7. Pending investigation 8. Could not be determined.
If deceased was a female, was pregnancy the death associated with? 1. Yes 2. No
If yes, was there a delivery? 1. Yes 2. No
Name and signature of the Medical Attendant certifying the cause of death
Date of verification ____________________________________________
(To be detached and handed over to the relative of the deceased)
Certified that Shri/Smt/Kum_________________________________________S/W/D of Shri ________________________________

R/O ___________________________________________________ was admitted to this hospital on __________________________
and expired on ______________________________________.
Doctor_____________________________________
(Medical Superintendent & Name of Hospital)
ANNEXURE-II
- 28 -
For Hospital Events
FORM NO. 4
(See Rule 7)

(Hospital In-patients. Not to be used for still births)
Name of the Hospital _________________________________________________________________

Ward No._______ On______________ At ___________ AM/PM.

statistical
years month
1, Male
2.Female
Interval between
approx.
I. Immediate cause: a) …………………… …

complication
mode of dying
Antecedent cause: b) …………………………


……………………………
Manner of Death How did the injury occur?

1. Disease 2. Accident 3. Assault 4. Intentional self-harm 5. Legal intervention. 6. War
7. Pending investigation 8. Could not be determined.
Date of verification ____________________________________________
Certified that Shri/Smt/Kum_________________________________________S/W/D of Shri ________________________________

R/O ___________________________________________________ was admitted to this hospital on __________________________
and expired on ______________________________________.
Doctor_____________________________________
(Medical Superintendent & Name of Hospital)
- 29 -
For Non-Hospital Events
FORM NO. 4 A
(See Rule 7)

(For non-institutional deaths. Not to be used for still births)
Name of the Hospital__________________________________________________________________

Ward No.______ On________________ At ____________AM/PM.

statistical
years month
1, Male
2.Female
Interval between
approx.

complication
mode of dying


……………………………
Date of verification_______________________________________________
Certified that Shri/Smt/Kum ________________________________________ S/W/D of Shri _________________________________

R/O______________________________________________ was under my treatment from _____________ to _________________
and expired on ______________________at _________________ AM/PM.
Doctor ____________________________________
Signature and address of Medical Practitioner/
Medical attendant with Registration No.
- 30 -
For Non-Hospital Events
FORM NO. 4 A
(See Rule 7)

(For non-institutional deaths. Not to be used for still births)
Name of the Hospital___________________________________________________ I hereby certify

that the person whose particulars are given below died in the hospital in Ward No.______
On________________ At ____________AM/PM.

statistical
years month
1, Male
2.Female
Interval between
approx.

complication
mode of dying


……………………………
Date of verification_______________________________________________
Certified that Shri/Smt/Kum ________________________________________ S/W/D of Shri _________________________________

R/O______________________________________________ was under my treatment from _____________ to _________________
and expired on ______________________at _________________ AM/PM.
Doctor ____________________________________
Signature and address of Medical Practitioner/
Medical attendant with Registration No.
- 31 -
05. Medical Sickness / Under Treatment Certificate
Recent
Name of Patient: _________________________________________________ Passport
size photo
Age: ________________________ Sex : _____________________________
Address : _______________________________________________________
OPD/IPD No._____________
ID Proof & No. (Any Govt ID) : ___________________________________
1. _______________________________________________________________________________
_________________________________________________________________________________
2. _______________________________________________________________________________
_________________________________________________________________________________
Signature & Thumb Impression of the Applicant: _________________________________________
I, Dr____________________________________ after careful personal examination of the case

hereby certify that ___________________________ whose signature is given above is suffering from
_________________________________.
He/she is under my treatment for the same as outdoor/indoor patient and I consider that a period
of absence from duty with effect from _____________ to ___________ (_____Days )
is absolutely necessary for the restoration of his/her health.
Place: Signature
Designation ________________________
- 32 -
- 33 -
06. Medical Fitness Certificate
Recent
Name of Patient: ________________________________________________ Passport size
photo
Age: _________________________ Sex: ___________________________
Address: ______________________________________________________
OPD/IPD No._____________
ID Proof & No. ( Any Govt ID ) : ___________________________________
1. _______________________________________________________________________________
_________________________________________________________________________________
2. _______________________________________________________________________________
_________________________________________________________________________________
Signature & Thumb Impression of the Applicant: _________________________________________
I, Dr ___________________________________ after careful personal examination of the case
hereby certify that ______________________________ on restoration of his/her health is now fit to
resume service from _____________________.
Place: Signature
Designation _______________________
- 34 -
- 35 -
07. Fitness Certificate for Employment
Recent
Passport
size photo
We hereby certify that, we have examined Shri/Smt. _______________________________________

a candidate for employment in the __________________________________ Department and cannot
discover that he/she has any disease, constitutional weakness or bodily infirmity except ___________
_________________________________________________________________________________
_________________________________________________________________________________.
Fit:
*He / She is Temp. Unfit:
Unfit:
We do not consider this is a disqualification for employment in the Office of ___________________

______________________. His / Her age is according to his/her own statement ________ years and
by appearance about __________________ years.
1. _______________________________________________________________________________
_________________________________________________________________________________
2. _______________________________________________________________________________
_________________________________________________________________________________
Signature/Thumb impression of the Candidate
Place: ___________________________
Date: ___________________________
Member Member Chairman

Medical Board Medical Board Medical Board
- 36 -
- 37 -
08. Examination \ Certificate of the injured (Injury Report)
1. Medico-legal injury cases should be examined without delay after adopting the lifesaving
procedure.
2. Valid consent for examination must be obtained from the injured or the competent authority.
3. All observation should be entered at once in the accident register with appropriate sketches and
diagrams. Injury should be photographed whenever possible.
4. Relevant information should always be entered in injury certificate or report and be prepared in
duplicate.
5. Whenever there is apprehension of death of the injured person or he is likely to die from the
effect of the injury, arrangement should be made for recording dying declaration.
Definitions:
Injury: Legal definition as per sec. 44 IPC.
Hurt: Legal definition as per sec. 319 IPC.
Simple injury:
Grievous hurt: Legal definition as per sec. 320 IPC.
- 38 -
Examination / Certification of Injured. [Injury Report]
To,
The Investigating Officer,
______________________ Police Station ___________________
Subject: Submission of report of examination of injured person
Reference: Your letter No. __________ Dated _____________
Sir,
I am forwarding herewith the report of examination of:
Name of Injured: _______________________ Son/Wife/Daughter/Widow of _________________
Surname _______________________________ resident of ________________________________
Brought by PC __________________NO._________________P.S. __________________________
Consent:
(This consent is explained to patient in ______________language). Signature/LTI

Identification marks: 1. ______________________________________________________________
2. ______________________________________________________________
History: History narrated by__________________________________________________________
Possible/ Age Remarks /
Sr. Size Situation over Type of
Nature of injury Kind of of Investigation
No. in cms the body injury
weapon injury done, if any
Opinion:
Place: Signature
Designation _______________________
- 39 -
To,
______________________ Police Station ___________________
Sir,
Consent:

2. ______________________________________________________________
Opinion:
Place: Signature
Designation _______________________
- 40 -
To,
______________________ Police Station ___________________
Sir,
Consent:

2. ______________________________________________________________
Opinion:
Place: Signature
Designation _______________________
- 41 -
To,
______________________ Police Station ___________________
Sir,
Consent:

2. ______________________________________________________________
Opinion:
Place: Signature
Designation _______________________
- 42 -
To,
______________________ Police Station ___________________
Sir,
Consent:

2. ______________________________________________________________
Opinion:
Place: Signature
Designation _______________________
- 43 -
09. Examination of Weapon
Definition:
Dangerous Weapon as per sec 324 & 326 IPC.:
Label various parts of ammunition of fire arm.
- 44 -
Draw & label Weapon Describe Weapon
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
- 45 -
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
- 46 -
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
Kind of Weapon-
Type of Weapon-
Injuries Possible-
- 47 -
1) Examination of the Weapon in Cases of Injuries (Sharp Edge Weapon)
To,
____________________Police Station ___________________
Sub: Submission of report of examination of weapon in connection with ________________
______________________________________________________________________
Reference:
1) Your letter No.___________________ Dated ____________ with sealed packed weapon.
2) Injury Report / MLPM No.: ____________ issued by _________________Date: __________
Sir,
With reference to the above letter, I am sending the report about the weapon sent in sealed
condition in connection with the injuries of ______________________________________________
Name of weapon _______________________________________
Kind of weapon _______________________________________
Type of weapon ________________________________________
Description of the weapon:
Weight of weapon: ____________________(gm)
Total length of weapon: ___________________(cms)
Blade: is of _____________, Texture: _____________
Length: _________________, Breadth: _________________, Thickness: _______________
Edges / Margins: _______________________ Point: _______________________________
Stains / Foreign body if any: ___________________________________________________
Joint: Type: _________________________, Hilt: Size: __________________________________
Handle: is of, ________________________ Texture: ____________________________________
Length: __________________ , Breadth/ Maximum Circumference: ___________________
Stains / Foreign body if any: __________________________________________________
Opinion:
Injuries possible by above weapon:
Identification marks if any on the weapon.

(Put the signature on the weapon)
The weapon was packed, sealed and handed over to _________________of police station_________
for forwarding to FSL for chemical analysis.
Place: ____________________ Signature

Date & Time: ______________ (Impression of seal) Name of Doctor _____________
Receipt of weapon and report Designation ________________
- 48 -
- 49 -
2) Examination of the Weapon in Cases of Injuries (Hard & Blunt weapon)
To,
____________________Police Station ___________________
Sub: Submission of report of examination of weapon in connection with ________________
______________________________________________________________________
Reference:
1) Your letter No.___________________ Dated ____________ with sealed packed weapon.
2) Injury Report / MLPM No.: ____________ issued by _________________Date: __________
Sir,
With reference to the above letter, I am sending the report about the weapon sent in sealed
condition in connection with the injuries of ______________________________________________
Name of weapon: _______________________________________
Kind of weapon: _______________________________________
Type of weapon: ________________________________________
Description of the weapon:
Weight of weapon: ____________________(gm)
Length: _________________Breadth / Maximum circumference: ______________________
Thickness: __________________________________________________________________
Surface: ____________________________________________________________________
Texture: ____________________________________________________________________
Stains / Foreign body if any: ____________________________________________________
Opinion:
Injuries possible by above weapon:
Identification marks if any on the weapon.

(Put the signature on the weapon)
The weapon was packed, sealed and handed over to _________________of police station_________
for forwarding to FSL for chemical analysis.
Place: ____________________ Signature

Date & Time: ______________ (Impression of seal) Name of Doctor _____________
Receipt of weapon and report Designation ________________
- 50 -
- 51 -
10. Medico-legal Examination of Survivors / Victims of Sexual Violence
Definition of Rape:
- 52 -
CONFIDENTIAL
Medico-legal Examination Report of Sexual Violence
1. Name of the Hospital _____________________ OPD No. ________ Inpatient No. ______________
2. Name _________________________________ D/o or S/o (where known) ____________________
3. Address __________________________________________________________________________
4. Age (as reported) ________________________ Date of Birth (if known) ______________________
5. Sex (M/F/Others) __________________________________________________________________
6. Date and Time of arrival in the hospital _________________________________________________
7. Date and Time of commencement of examination _________________________________________
8. Brought by______________________________ (Name & signatures)
9. MLC No. ________________________________Police Station______________________________
10. Whether conscious, oriented in time and place and person __________________________________
11. Any physical/intellectual/psychosocial disability __________________________________________
(Interpreters or special educators will be needed where the survivor has special needs such as
hearing/speech disability, language barriers, intellectual or psychosocial disability.)
12. Informed Consent/refusal
I____________________________________D/o or S/o ____________________________________
hereby give my consent for:
a) Medical examination for treatment Yes/No
b) This medico-legal examination Yes/No
c) Sample collection for clinical & forensic examination Yes/No
I also understand that as per law the hospital is required to inform police and this has been explained
to me. I want the information to be revealed to the police Yes/No
I have understood the purpose and the procedure of the examination including the risk and benefit,
explained to me by the examining doctor. My right to refuse the examination at any stage and the
consequence of such refusal, including that my medical treatment will not be affected by my refusal,
has also been explained and may be recorded. Contents of the above have been explained to me
in_______________________ language with the help of a special educator/interpreter/support person
(circle as appropriate) _____________________________.
If special educator/interpreter/support person has helped, then his/her name and signature___________
Name & signature of survivor or

Name & signature/thumb impression of Witness parent/Guardian/person in whom the
_______________________________________ child reposes trust in case of child (<12 yrs)
_______________________________________ ____________________________________
____________________________________
With Date, time and place With Date, time and place
13. Marks of identification (Any scar/mole):
(1) ___________________________________________________________
___________________________________________________________
(2) ____________________________________________________________
____________________________________________________________ Left Thumb impression
- 53 -
14.Relevant Medical/Surgical history
Onset of menarche (in case of girls) – Yes/No Age of onset _____________________________
Menstrual history – Cycle length and duration ______________Last menstrual period___________
Menstruation at the time of incident -Yes/No, Menstruation at the time of examination - Yes/ No
Was the survivor pregnant at time of incident - Yes/No, If yes duration of pregnancy _______ weeks
Contraception use: Yes/No_____________ If yes – method used:____________________________
Vaccination status – Tetanus (vaccinated/not vaccinated), Hepatitis B (vaccinated/not vaccinated)
15A. History of Sexual Violence

(i)Date of incidents being reported (ii)Time of incidents/s (iii)Location/s
(iv)Estimated duration: 1-7 days______ 1 week to 2 months ___________2-6 months __________
>6 months________________________ Episode: One ___________________________________
Multiple _________________________Chronic (>6 months) _____________________________
Unknown _______________________________________________________________________
(v) Number of assailants and name/s _________________________________________________
(vi)Sex of Assailant(s) _______________ Approx. Age of assailant (s) ______________________
If known to the survivor- relationship with the survivor __________________________________
(vii) Description of incident in the words of the narrator: narrator of the incident:
Survivor/informant( specify name and relation to survivor)________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
If this space is insufficient use extra page.
15B. Type of physical violence used if any (Describe):

Hit with (Hand, fist, blunt object, sharp object) Burned with
Biting Kicking
Pinching Pulling hair
Violent shaking Banging head
Dragging Any other
- 54 -
15C.
i. Emotional abuse or violence if any (insulting, cursing, belittling, terrorizing) _________________
ii. Use of restraints if any ___________________________________________________________
iii. Used or threatened the use of weapon(s) or objects if any________________________________
iv. Verbal threats (for example, threats of killing or hurting survivor or any other person in whom the
survivor is interested; use of photographs for blackmailing, etc.) if any: ____________________
______________________________________________________________________________
v. Luring (sweets, chocolates, money, job) if any ________________________________________
vi. Any other: ____________________________________________________________________
15D.
i. Any H/O drug/alcohol intoxication: __________________________________________________
ii. Whether sleeping or unconscious at the time of incident: _________________________________
15E. If survivor has left any marks of injury on assailant/s, enter details: __________________________
15F. Details regarding sexual violence:

Was penetration by penis, fingers or object or other body parts (Write Y=Yes, N=No, DNK=Don't
know) Mention and describe body part/s and/or object/s used for penetration.
Penetration Emission of semen
Orifice of By penis By body part of By Yes No Don’t
victim self or assailant or object know
third-party finger,
tongue or any
other)
Genitalia
(vagina and/
or urethra)
Anus
Mouth
Oral sex performed by assailant on survivor Y N DNK

Forced masturbation of self by survivor Y N DNK
Masturbation of assailant by survivor, forced manipulation of Y N DNK
genitals of assailant by survivor
Exhibitionism (perpetrator displaying genitals) Y N DNK
Did ejaculation occur outside body orifice Y N DNK
(Vagina/anus/mouth/urethra)?
If yes, describe where on body
Kissing, licking or sucking any part of survivor’s body Y N If yes, describe
Touching/ fondling Y N If yes, describe
Condom used* Y N DNK
If yes, status of condom Y N DNK
Lubricant used* Y N DNK
If yes, describe kind of lubricant used
If object used, describe object:
Any other form of sexual violence
*Explain what condom and lubricant is to the survivor
- 55 -
Post incident has the survivor Yes/No/Do not know Remarks
Changed clothes
Changed undergarments
Cleaned/washed clothes
Cleaned/washed clothes undergarments
Bathed
Douched
Passed urine
Passed stools
Rinsing of mouth/brushing/vomiting (circle any or all as
appropriate)
Time since incident _________________________________________________________________
H/o vaginal/anal/oral bleeding/discharge prior to the incident of sexual violence _________________
H/o vaginal/anal/oral bleeding/discharge since the incident of sexual violence __________________
H/o painful urination/ painful defecation/ fissures/ abdominal pain/pain in genitals or any other part
since the incident of sexual violence ___________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
16. General Physical Examination-
i. Is this the first examination ________________________________________________________
ii. Pulse ________________________________ BP _____________________________________
iii. Temp ________________________________Resp. Rate _______________________________
iv. Pupils ________________________________________________________________________
v. Any observation in terms of general physical wellbeing of the survivor _____________________
17. Examination for injuries on the body if any

The pattern of injuries sustained during an incident of sexual violence may show considerable
variation. This may range from complete absence of injuries (more frequently) to grievous injuries
(very rare).
(Look for bruises, physical torture injuries, nail abrasions, teeth bite marks, cuts, lacerations,
fracture, tenderness, any other injury, boils, lesions, discharge specially on the scalp, face, neck,
shoulders, breast, wrists, forearms, medial aspect of upper arms, thighs and buttocks) Note the
Injury type, site, size, shape, colour, swelling signs of healing simple/grievous, dimensions.)
Scalp examination for areas of tenderness, if hair pulled out/
dragged by hair)
Facial bone injury: Orbital blackening, tenderness
Petechial haemorrhages in eyes and other places
Lips and Buccal mucosa/ gums
Behind the ears
Ear drum
Neck, Shoulders and Breast
Upper limb
Inner aspect of upper arms
Inner aspect of thighs
Lower limb
Buttocks
Other, please specify
- 56 -
18. Local examination of genital parts/other orifices*
A. External genitalia: record finding and state NA where not applicable.
Body parts to be examined Findings
Urethral meatus and vestibule
Labia majora
Labia minora
Fourchette and introitus
Hymen
Perineum
External urethral meatus
Penis
Scrotum
Testes
Clitoropenis
Labioscrotum
Any other
B. Per Vaginum /Per Speculum examination should not be done unless required for detection of
injuries or for medical treatment.
P/S findings if performed __________________________________________________________
P/V findings if performed _________________________________________________________
Record reasons if P/V of P/S examination performed____________________________________
- 57 -
C. Anus and Rectum (encircle the relevant)
Bleeding/tear/discharge/oedema/tenderness
_______________________________________________________________________________
_______________________________________________________________________________
D. Oral Cavity - (encircle the relevant)
Bleeding/ discharge/ tear/oedema/ tenderness
_______________________________________________________________________________
_______________________________________________________________________________
19. Systemic examination:

1) Central Nervous System: __________________________________________________________
2) Cardio Vascular System: __________________________________________________________
3) Respiratory System: ______________________________________________________________
4) Chest: _________________________________________________________________________
5) Abdomen: ______________________________________________________________________
20. Sample collected/ Investigations for hospital laboratory/ clinical laboratory:
1. Blood for HIV, VDRL, HbsAg ______________________________________________________
2. Urine test for pregnancy ___________________________________________________________
3. Ultrasound for pregnancy/ internal injury ______________________________________________
4. X-ray for injury __________________________________________________________________
21. samples collection for central /state forensic laboratory.
1. Debris collection paper ____________________________________________________________
2. Clothing evidence where available-(to be packed in separate paper bags after air drying)
- 58 -
List of Details of clothing worn by the survivor at time of incident of sexual violence
3. Body evidence samples as appropriate (duly labelled and packed separately)

Collected/ Not Reason for not
collected collecting
Swabs from stains on the body (Blood, semen,
foreign material, others)
Scalp hairs (10-15 strands)
Head hair combing
Nail scrapings (Both hands separately)
Nail clippings (Both hands separately)
Oral swab
Blood for grouping, testing drug/ alcohol
intoxication (plain vial)
Blood for alcohol levels (Sodium fluoride vial)
Blood for DNA analysis (EDTA vial)
Urine (drug testing)
Any other (tampon/sanitary napkin/condom/object)
4. Genital and anal evidence (each sample to be packed, sealed and labelled separately to be placed in bag).
* swab sticks for collecting samples should be moistened with distilled water provided.
Collected / Not Reason for not
collected collecting
Matted pubic hair
Pubic hair combing (mention if shaved)
Cutting of pubic hair (mention if shaved)
Two vulval swabs (for semen examination and
DNA testing)
Two vaginal swabs (for semen examination and
DNA testing)
Two anal swabs (for semen examination and DNA
testing)
Vaginal smear (air-dried) for semen examination
Vaginal washing
Urethral swab
Swab from glans penis/ clitoropenis
*samples to be preserved as directed till handed over to police along with duly attested sample seal.
- 59 -
22. Provisional medical opinion:
I have examined (survivor) _____________________________ M/F/other _________aged _______
reporting (type pf sexual violence and circumstances) _________________ days/hours after incident,
after having (bathed/douched) _____________________ my findings are as follows:
*samples collected (for FSL) awaiting reports ____________________________________________
*samples collected (for hospital laboratory) ______________________________________________
*clinical findings ___________________________________________________________________
*Additional observations (if any) ______________________________________________________
23. Treatment prescribed:
Treatment Yes No Type and comments
STI prevention
treatment
Emergency
contraception
Wound treatment
Tetanus prophylaxis
Hepatitis B vaccination
Post exposure
prophylaxis for HIV
Counselling
Other
24. Date and time of completion of examination _____________________________________________
This report contains ___________number of sheets and __________________number of envelopes.
Place: ________________ Signature of examining doctor/s_______________

Date: ________________ Name of examining doctor/s__________________
Seal
25. Final opinion: (After receiving lab reports)
Findings in support of the above opinion, taking into account the history, clinical examination
findings and laboratory reports of _______________________________ bearing above identification
marks described above _______________________ hours/days after the incident of sexual violence,
I am opinion that: __________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Place: ________________ Signature of examining doctor/s_______________

Date: ________________ Name of examining doctor/s__________________
Seal
*copy of the entire report must be given to the survivor/ victim free of cost immediately.
- 60 -
- 61 -
11. Examination of Accused of Sexual Violence
Name of Hospital:_ _________________________________________________________________
OPD/ IPD No: ____________________ MLC No : _________________ Date : _________________
1. Case Particulars:
Requisition from ___________________vide letter No. ______________ Dated __________
brought and identified by ______________________________________________________
2. Particulars of the alleged accused:
i. Name: __________________________________ S/o ______________________________
ii. Address: _________________________________________________________________
iii. Age as stated ___________________ iv. Occupation _____________________________
v. Married/Single/Divorcee ___________ vi. Religion: ______________________________
vii. Marks of Identification:
(a) _____________________________ (b) _______________________________________
viii. Examined in presence of (name with signature) _______________________________
3. Consent given in writing
I _____________________ _________________________ hereby voluntarily consent and agree to following
( Mark each that applies)
a) Medical examination and examination of genitals, examination of other secondary sexual
characters and examination of other body parts.
b) Collection of samples for medical and Forensic examination and treatment.
All this has been explained to me in the manner and language, which I can understand
Left Thumb impression Signature of accused/ Guardian
Note: Age estimation is mandatory if the alleged accused is minor

4. Brief History:
i. As given by police: __________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
ii. As given by alleged accused:
a. If he admits or denies the incidence(Account of incidence as per his statement)
b. Did he know the victim before? _______________________________________________
c. Date and time of incidence: ___________________________________________________
d. Any history of S.T.D : YES / NO ______________________________________________
e. Did he take bath, wash etc. after the alleged incidence? : YES / NO ___________________
f. Has he changed clothes after the incidence? : YES / NO ___________________________
g. Condom used while sexual intercourse: YES / NO ________________________________
h. Frequency and number of sexual intercourse: _____________________________________
i. Brief description of acts of penetration/ejaculation: _________________________________
j. History of alcohol/other drug abuse: ____________________________________________
k. Allergies: ____________________ Current medication: ____________________________
l. Any Relevant Surgical history: _________________________________________________
m. Any other: _________________________________________________________________
- 62 -
5. Physical examination:
Clothing: If same was worn during the incidence look for presence of blood stains, semen,
vaginal stain, female pubis hair, mud, grass, lipstick, any tear etc. and describe
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
6. General examination:
Height: ________________ Weight: _________________ Body Built: _________________
Blood Pressure: ___________ Pulse: _________________ RR: _______________________
Axillary hair: ________________________________________________________________
Beard & Moustaches: _________________________________________________________
Pubic hair (including tanner staging) _____________________________________________
Dentition: (8/8) ______________________________________________________________
7. Systemic Examination
CNS : (Mental status) ________________________________________________________
CVS: ____________________________ RS: ______________________________________
8. Marks of violence if any (Tick mark if present and describe):

Bite marks: _________________________________________________________________
Abrasions: __________________________________________________________________
Contusions: _________________________________________________________________
Any other: _________________________________________________________________
9. Genital Examination:
a. (Indicate as Y = Yes, N = No)
Observation Pubic region Thigh and adjoining part
Matted hair
Seminal stain
Blood
Loose foreign hair
b. Penis:
Observations Remark
Development (Tanner Stage)
Any defect/ Deformity
Whether foreskin can be freely rolled up or is
circumcised
Evidence of any disease e.g. STD
Presence of smegma under the foreskin
Hair under prepuce
Any stains nearby
Injuries over Genital:
Prepuce: ____________________________________________________________________
Glans penis: _________________________________________________________________
Frenulum: __________________________________________________________________
Scrotum: ___________________________________________________________________
Any other: __________________________________________________________________
- 63 -
10. Sample collection for Hospital/Clinical Laboratory
Sr Sample Name Test For Preservative/ Yes/No
No Packing collected?
1. Urethral Swab Microscopy& Culture Plain Sterile Bulb
2. Swab from discharge Microscopy& Culture Plain Sterile Bulb
3. Blood Serology (For STD and Hep. B) Plain Sterile Bulb
4. Urine (midstream) Microscopy& Culture Plain Sterile Bulb
Note: Every forensic examination room should have adjacent laboratory for detection of sperms and
vaginal epithelium (Lugol’s iodine test).
11. Collection of Samples for Forensic Analysis:
a) Clothing, where available (Each garment to be wrapped separately and packed in paper
bags after air drying) _______________________________________________________
________________________________________________________________________
________________________________________________________________________
b) Sample collection for Forensic science laboratory:
Sr Name of sample Test (for evidence of) Preservative / Collected
No Packing YES/NO
1 Clothes (outer & inner) For identification of any biological stains/ Paper envelope
material from victim and scene of crime
2 Matted pubic hair For detection of semen and identification Paper envelope
of any hairs from victim
3 Combed pubic hairs To identify foreign hairs by comparing Paper envelope
with victim
4 Scalp hairs (10 to 15) For comparison those found on victim and Paper envelope
scene of crime
5 One swab & smear For detection of vaginal/buccal epithelial Sterile tube &
from prepuce, coronal cells and DNA Paper envelope
sulcus
6 One swab & smear For detection of vaginal/buccal epithelial Sterile tube &
from glans and urethral cells and DNA Paper envelope
meatus
7 Scrotal swab and For detection of any biological stains Sterile tube
smear
8 Swab and smear from For detection of any biological stains Sterile tube &
stains on body Paper envelope
9 Penile washing For detection of vaginal/buccal epithelial Sterile tube
cells and DNA
10 Buccal swab and smear For detection of any biological stains and Paper envelope
DNA
11 Nail clipping / For detection of skin, blood, hair fiber of Paper envelope
scrapping victim if human tissue blood group and
DNA
12 Blood Blood grouping Plain bulb
13 Blood DNA analysis EDTA bulb
14 Blood Drugs /alcohol Fluoride and
oxalate bulb
15 Urine Drugs /alcohol Fluoride bulb
16 Other object if any For detection of vaginal/buccal epithelial Sterile tube &
swab and smear cells and DNA Paper envelope
Note: Samples must be collected as per time elapsed between assault and examination, history received
from alleged accused and clinical examination.
- 64 -
12. Provisional opinion:
I have examined _____________________________________________ Sex __________________
Aged ___________ reporting on dated ________________, ________ days/hours after the incidence.
My findings are as follows:
• Samples collected (for FSL): __________________________________________________
• Samples collected (for hospital laboratory): _______________________________________
• Significant clinical findings: ___________________________________________________
• Additional observations (if any): _______________________________________________
“The Opinion is kept pending awaiting the above laboratory reports”.
(This report contains ___________ number of sheets and _________________number of envelopes.)
Place: ________________ Signature of examining doctor_______________

Name of examining doctor__________________
Seal
13. Final Opinion (After receiving Lab reports)

Taking into consideration the history of the case, the data on clinical examination and the report of
FSL (all being considered together) and other investigations
A. 1. Penetrative sexual assault i.e., of vaginal/ anal/ urethral/ oral penetration by the male
sex organ. (when presence of genital & physical injuries & the subject’s penile
washings show vaginal / buccal epithelium or faecal matter)
2. Sexual assault by objects other than genitals (when presence of physical injuries &
the object shows presence of vaginal /buccal epithelium or faecal matter)
3. No sexual and penetrative assault.
B. Intoxications (Lab report positive for drugs/alcohol)
C. Injuries suggestive of sexual assault (when presence of genital & physical injuries over
body & the subject’s penile washings are negative for vaginal/buccal epithelium or
faecal matter)
D. Any other comments: _____________________________________________________

______________________________________________________________________
Place: _____________________ Signature of examining doctor/s_______________

Date & Time: _______________ Name of examining doctor/s _________________
Seal
- 65 -
12. Potency Certificate
Name of the Hospital: _____________________________________ MRD No: _________________

Name of Person: ___________________________________________________________________
Age: _________ yrs, Sex: ___________, Marital Status: ____________________
Address: _________________________________________________________________________
Brought By: _______________________________________________________________________
MLC No: ________________________ (If Applicable)
Consent: _________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
(This consent is explained to patient in _____________language)
Identification Mark:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. Left Thumb Impression
History:
1. Present History: ______________________________________________________________
___________________________________________________________________________
2. Past History: ________________________________________________________________
___________________________________________________________________________
3. Sexual History: ______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Examination:
1. General Examination:
i) Height: _______________________________________________________________
ii) Weight: ______________________________________________________________
iii) Physical Development: __________________________________________________
iv) Secondary Sexual Characters: _____________________________________________
v) Any Disease / Deformity: ________________________________________________
vi) Examination of spine: ___________________________________________________
- 66 -
Systemic Examination
i) C.V.S.: _______________________________________________________________
ii) R.S.: _________________________________________________________________
iii) G.I.T.: _______________________________________________________________
iv) C.N.S. _______________________________________________________________
2. Local Examination:
i) Penis: ________________________________________________________________
Development: _________________________________________________________
Sensation over glans: ___________________________________________________
Disease / Deformity: ____________________________________________________
Injury: _______________________________________________________________
Any other: ____________________________________________________________
ii) Scrotum: _____________________________________________________________
Testis: _______________________________________________________________
Descended / Undescended: _______________________________________________
Disease / Deformity: ____________________________________________________
iii) Epididymis / Spermatic Cord: _____________________________________________
3. Psychological Examination
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
4. Laboratory Test:
1.
2.
3.
4.
5.
Opinion: _________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Designation _____________________
- 67 -
- 68 -
- 69 -
13. Examination of Alcoholic Person (Drunkenness)
AIM:
a) To decide whether the subject is under the influence of alcohol, and if so to what extent.
b) To decide whether his condition is due to illness or injury;
c) To decide whether it is safe for him to be detained in a police station or to decide whether he is
to be admitted to a hospital.
A doctor should attend the case as soon as possible without any delay.
DEFINATION:
Drunkenness: ‘It is a condition produced in a person who has taken alcohol in a quantity sufficient to
cause him to lose control of his faculties to such an extent, that he is unable to execute safely, the
occupation in which he is engaged at the particular time.’
Use of alcohol in human population –
_________________________________________________________________________________
_________________________________________________________________________________
Laboratory investigations –
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Clinical Interpretation
a). The individual examined has not consumed alcohol.

No smell of alcohol in breath and / or lab analysis is negative, clinical examination normal.
b) The individual examined has consumed alcohol but not under influence of it.
Smell of alcohol in breath present and / or lab. Analysis reveals the presence of alcohol, but clinical
examination reveals normal findings.
c) The individual examined has consumed alcohol and is under influence of it.
Smell of alcohol in breath present and / or lab. Analysis reveals the presence of alcohol, and clinical
examination reveals abnormal findings (definite signs of muscular in co-ordination, dilated pupils
with sluggish reaction to light, fine lateral nystagmus, slurred in-coherent speech, staggering gait,
delayed reaction time, etc).
Under the influence (100 -200mg%) – flushed face, dilated sluggish pupil, euphoria, loss of
restrain, increased reaction time, test errors, stagger on sudden turning.
Drunk (200-300mg%) - flushed face, dilated sluggish inactive pupils, clouding of intellect,
incoordination of thoughts, speech and action, staggering gate with reeling and lurching while
making sudden turn.
Very drunk – flushed or pale face, pupils inactive contracted or dilated, mental confusion, marked
incoordination of thoughts, speech and action, staggering and reeling gate with tendency to lurch
and fall, vomiting, amnesia.
- 70 -
Differential Diagnosis of Alcohol Intoxication
Head injury. Cerebral tumour, Incipient C.V.A., Epilepsy, Disseminated sclerosis. Acute aural vertigo.
Hypoglycaemia, Hyperglycaemia, Thyrotoxicosis, Delirium. Uraemia, Hepatic failure. Fatigue,
Carbon monoxide poisoning, Hypomania, Psychosis, Hysteria and, Drugs esp. Insulin, Barbiturates,
Antihistamines, Narcotics, Sedatives, Antidepressants.
Medico-Legal Aspects of Drunkenness

Drunkenness and criminal responsibility –
• Sec 85 IPC – act of a person incapable of judgment of reason of intoxication caused against
his will.
• Sec 86 IPC – offence requiring a particular intent or knowledge, committed by one who
is intoxicated.
Drunkenness and consent –

• Sec 90 IPC – the consent given by an insane or intoxicated person who is unable to understand
the nature and consequences of that to which he gives his consent is invalid.
Drunkenness and driving –

• Sec 185 of Motor Vehicle Act (1988, Amend. 1994) – 30 mg%
• Sec 279 IPC – Rash driving on a public way
• Sec 287 IPC – Negligent conduct with respect to machines.
Drunkenness and disturbance of the peace –

• Sec 510 – Misconduct in by drunken person
Medico-legal examination
• Sec 53 & 54 Cr.P.C
Bombay High court ruling – collection of samples does not violate constitutional right to privacy
- 71 -
Examination of Alcoholic Person (Drunkenness)
Date:
To,
The Investigating officer,
____________________Police station____________________
Subject: Regarding examination of person with alleged history of intoxication.
Reference: Your letter No ______________Dated __________Police Station___________________
Date and Exact time of examination:
Name of Person examined________________________________________, Age______ (in years)
Address: ____________________________Occupation: ___________________________________
Consent: (Informed consent) _________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
(This consent is explained to patient in ___________language)
Signature / Thumb impression
(Subject/Guardian)
Examined in presence of-
Identification marks: (At least two unique identification marks)

i) ___________________________________________________________________________
ii) ___________________________________________________________________________
iii) Left Thumb Impression
History:
As stated by person examined_________________________________________________________
a. Has he consumed alcohol? If so, note the time, nature & quantity of the drink? ________________
b. What food and drink he took last and when? ___________________________________________
c. H/o fits, illness or other disability? ___________________________________________________
d. Is he Chronic alcoholic? Frequency of alcohol intake? ___________________________________
e. History of any medication? Nature & dose? ____________________________________________
f . H/o Diabetes? Time of insulin taken & dose taken? _____________________________________
- 72 -
General appearance and demeanor:
a. State of clothing- Decent, disarrayed, soiled

b. Disposition- Calm, talkative, abusive, obscene
c. Speech- Incoherent/ slurred/clear
d. Gait- Steady/ staggering, self-control
General examination-
1) B.P.: _________________ ________________________________________________________

2) Pulse (rapid & bounding, slow, etc.): __________________________________________________
3) Temperature (surface temp. raised, lowered, normal): ____________________________________
4) Skin (dry, moist, flushed or pale): ____________________________________________________
5) Mouth (smell of alcohol, dribbling of saliva, ___________________________________________
furred tongue, dry lips, etc.): _______________________________________________________
6) Eyes (lids swollen or red, conjunctivae congested or _____________________________________
not, visual acuity, pupils dilated or contracted, ________________________________________
nystagmus (+/-) & reaction of pupil to light & accommodation): __________________________
7) Gait:
(a) Manner of walking (unsteady/ steady). _______________________________________
(b) Reaction time to a direction to turn. __________________________________________
(c) Manner of turning (normal/ staggering). ______________________________________
8. Muscular coordination: ____________________________________________________________
(Perform any of the test enumerated below

a. Walking along a straight line, b. Finger nose test ________________________________________
c. Picking up a coin from the floor, d. Romberg’s sign/test __________________________________
e. Handwriting, f. Copying simple geometric figures) ______________________________________
Examination of System (to exclude any other condition)
a. Central Nervous system ___________________________________________________________
b. Cardiovascular system ____________________________________________________________
c. Respiratory System_______________________________________________________________
d. Abdomen _______________________________________________________________________
- 73 -
Examination of bodily Injuries (If any): _______________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Laboratory investigation:
Blood / Urine for chemical examination: ________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Any other: ________________________________________________________________________
_________________________________________________________________________________
Diagnosis: ________________________________________________________________________
_________________________________________________________________________________
Opinion: I am of opinion that the above person has:
(1) Consumed alcohol and is under its influence.
(2) Consumed alcohol, but is not under its influence.
(3) Not consumed alcohol.
Place: Signature of Doctor:

Date: Name:
Designation:
- 74 -
Chapter—XIII—Blood Test
{136} THE BOMBAY PROHIBITION (MEDICAL EXAMINATION AND BLOOD TEST)
RULES, 1959
“Registered Medical Practitioner” means any registered medical practitioner authorised by general
or special order by the State Government under sub-section (4) of section 129-A of the Act;
“Testing Officer” means the Chemical Examiner or assistant Chemical examiner to government or
any other officer appointed by the State Government for testing blood under sub-section (1) of section
129-A of the Act.
Medical examination.––A registered medical practitioner before whom a person is produced under
sub-section (1) of section 129-A of the Act by a Police Officer or a Prohibition Officer for the purpose
of medical examination of such person or collection of his blood, shall examine such person and if he
deems necessary, collect and forward in the manner prescribed in these Rules, the blood of such person
and furnish to the officer by whom such person was produced a certificate in Form ‘A’ containing the
result of his examination and shall keep a copy of such certificate on his record.
Manner of collection and forwarding of blood––
(1) The registered medical practitioner shall use a syringe for the collection of the blood of the person
produced before him under rule 3 the syringe shall be sterilised by purring in boiling water before
it is used for the aforesaid purpose. He shall clean with sterilized water and swab the skin surface
of the part of such person’s body from which he intends to withdraw the blood. No alcohol shall
be touched at any stage while withdrawing blood from the body of the person. He shall withdraw
not less than 5 c. c. of venous blood in the syringe from the body of the person. The blood collected
in the syringe shall then be transferred into a phial containing anti-coagulant and preservative and
the phial shall then be shaken vigorously to dissolve the anti-coagulant and preservative in the
blood. The phial shall be labelled and its cap sealed by means of sealing wax with the official seal
or the monogram of the registered medical practitioner.
(2) The sample blood collected in the phial in the manner stated in sub-rule (1) shall be forward for
test to the Testing Officer either by post or with a special messenger so as to reach him within
seven days from the date of its collection. It shall be accompanied by a forwarding letter in form
‘B’ which shall bear a facsimile of the seal or monogram used for sealing the phial of the sample
blood.
Certificate of test of sample blood. ––The Testing Officer shall on receipt of the sample blood, test it
and shall certify the result of his test in Form ‘C.’ The Testing Officer shall send the certificate in
duplicate to the registered medical practitioner by whom the blood was forwarded to him for test and
retain a copy thereof on his record. On receipt of the certificate from the Testing Officer, the registered
medical practitioner shall forward the original copy of the certificate to the Police Officer or the
Prohibition Officer concerned. The duplicate copy of the certificate shall be kept by him on his record.
- 75 -
FORM ‘A’
(See rule 3)
Certificate by a registered medical practitioner showing whether a person examined by him has or
has not consumed an intoxicant.
Serial No._______________________________ (Name and location of the Dispensary or Hospital)
Certified that Shri/Smt./Kumari. _______________________________________________________

of ________________________ was brought to this hospital/dispensary by ____________________
___________________ (here state name and designation of the Officer) on __________20___, at______ A.M./P.M.
and was examined by me on __________20___, at______ A.M./P.M
A clinical examination of the above-named person disclosed the following:

Age __________________
Weight _______________
Smelling
Breath :
(Alcohol / ganja /bhang/ Not smelling
charas / opium)
Incoherent
Speech :
Normal
Unsteady
Gait :
Steady
Dilated
Pupils :
Normal
Additional remarks, if any. : ____________________________________________________
has consumed alcohol/opium/ charas/ ganja/ bhang.

I find that the above-named person
has not consumed any intoxicant.
is
I also find that he under the influence of alcohol.
is not
N. B.––
was
(Blood from the body of the above named collected by me for chemical examination).
was not
Dated: ______________20___ (Signature) ______________________________

Place: ___________________ Designation _____________________________
Signature/Thumb-impression
of the person examined.
Marks of identification of the person examined in case he refuses to give his signature or thumb-impression.
–––––––––
- 76 -
FORM ‘B’
[See rule 4 (2)]
No. ______________________________
From
_______________________________________________________________________
(Name, designation and address of the registered medical practitioner.)
To,
______________________________________________________________________________
(Name, designation and address of the Testing Officer.)
Dated _________________ 20
Sir,
I, forward herewith by post/with Shri* __________________________________________________
of _____________________________ a phial bearing serial No. _____________________________
containing________________ c. c. of venous blood collected by me on________________________
at. ______________________ A.M./P.M. of __________________________________________
who was produced before me for medical examination †and / or collection of blood from his / her body
‡ by _____________________________________________________________________________
and request you to test the blood and issue a certificate (in duplicate) regarding the result of the test.
Yours faithfully,
Signature and designation of the
registered medical practitioner.
Facsimile of the seal or monogram used for

sealing the phial containing the blood.
* Here specify the name, designation and address of the messenger with whom the phial containing
the blood is forwarded for delivery to the Testing Officer.
† Strike off, if these words are not required.
‡ Here state the name and designation of the officer by whom the said person was produced for
collection of blood.
- 77 -
FORM ‘C’
(See rule 5)
Alcohol Examination Certificate
No. R ______________of __________________
I. Case No. ______________________________
Dated __________________________
From,
_________________________________________________________________________________
(Here mention name, designation and address of testing officer.)
To,
(_______________________________________________________________________________ ,
(Here mention the name, designation and address of Registered Medical Practitioner.)
Your letter No. __________________Dated _____________, forwarding a phial containing blood of
Shri/Smt./Kumari. __________________________________________________________________
of _______________________________________ bearing Serial No.________________________
labelled. ___________________________________ received here on ________________________
by post/with messenger Shri ____________________of ____________________________________
sealed/unsealed, seal perfect and as per copy sent/seals intact device no copy sent.
Result of the test of the blood

The blood contained __________________________ per cent. W/V of ethyl-alcohol.
Method, Factual Data and Reasons leading to the Result of Blood analysis
(1) Method of Analysis—Modified Cavette’s Method Journal Analytical Chemistry, 1959, 31, 1908. It
is based on oxidation of alcohol by chromic acid as that in Cavette’s Method but the oxidation is carried
out in vacuum and at room temperature. It takes only a fraction of a minute instead of a few hours to
complete the reaction. Ketonic bodies are volatile acids do not interfere in this method. All usual
precautions essential in microanalytical work mentioned in the paper referred to above have been
strictly followed, e.g., all chemical used in the test were of reagent quality the apparatus was first
cleaned with hot chromic acid, then repeatedly with tap water and finally with distilled water. 2[It was
then dried in hot air oven.] No grease was used anywhere in the apparatus. The atmosphere of the room
where the test was caried out was free from all gases or suspended impurities. Fresh glass-distilled
water used throughout the test.
(2) Factual Data and Reasons for arriving at the findings pertaining to the blood sample in question.-
Analysed on ______________________________________________________________________
Smell: Nothing to note/Has characteristic smell of ________________________________________
Quantity of blood taken for analysis : 0.5 ml.
Quantity of N/20 dichromate taken : 5.00 ml.
Quantity of N/20 dichromate used up in oxidising alcohol in the sample ____________ ml.
1 ml. of N/20 dichromate oxidises 0.000575 gramme of ethyl-alcohol.
2[Therefore, 100 ml. of blood contained. 0.000575 x ________ ml. of dichromate used x 100
__________________________________gramme of 0.50 ethyl-alcohol.]
Signature and Designation of testing officer

___________________________________________________
Note.—(1) WV = _________________________ grammes of ethyl-alcohol in 100 c. c. of blood.
(2) The blood sample was stored in refrigerator from the time it was received in the laboratory till
it was taken for analysis.
1. Subs. by G. N. of 26-9-1963.
2. Subs. by G. N. of 6-12-1963.
- 78 -
- 79 -
- 80 -
- 81 -
Format of Medico-Legal report of a person in Police, Judicial Custody or Referred by court of Law and
Violation of Human rights as requirement of NMRC, who has been brought for Medical Examination.
14. Medico-Legal Examination of person at the time of entry into in Police /

Judicial Custody and periodically thereafter
To, Date:
_____________________Police station, _____________________
Sub: - Submission of Medico-legal report of person in Police / Judicial Custody
Ref: - 1. Your Order / letter No._______________________ Dated___________________________
2. Case No.__________________________________________________________________
Sir,
I /We hereby certify that, I/We have examined Mr./Mrs. ____________________________________
S/O or D/O _________________________________ Age (as Stated)___________ Sex___________
Residing at ________________________________________ as a person in police / Judicial custody
brought by PC/PN/HC________________________ of ________________________ Police station.
Consent for Medical Examination:
_________________________________________________________________________________
_________________________________________________________________________________
(Subject/Guardian)
Examined in presence of-
Date and time of admission in prison: ___________________________________________________
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3 Left Thumb Impression
Previous history of illness: ______________________ History of drug abuse, if any? ___________
Any information the prisoner may volunteer: _____________________________________________
Physical Examination:
Hight____________ Weight________________ Pulse _______/sec BP_______/_____of Hg
RR________/ min Temperature __________ LMP:_______________
Pallor: _______________ Clubbing: ______________ Cyanosis: _____________ Icterus: ________
CNS_____________________________________CVS____________________________________
RS______________________________________GIT_____________________________________
Eye/ENT________________________________ Urinary system____________________________
- 82 -
Investigations, if any clinically required:
Pathological tests: ____________________________________________________________
X-ray Chest: _______________________
ECG: _____________________________
Blood tests: _________________________________________________________________
Bodily Injuries if any:

_________________________________________________________________________________
_________________________________________________________________________________
(Please see for all body areas & Prepare Separate Injury report of if any injury/injuries are present)
(If any history of previous mental illness/ finding of suicidal tendencies etc., psychiatrist’s opinion to be sought)
(The medical examination and investigations were conducted with the consent of the prisoner after
explaining to him/ her that it was necessary for diagnosis and treatment.)
The Medical examination done on Mr.__________________________________________, By Me/Us

bearing above mentioned identification marks does not show any disease, constitutional weakness or
bodily infirmity except__________________________________________________________(NIL)
- Fit.
He
is -Temporary Unfit.
She
- Unfit.
Time of commencement of medical examination:

Date of completion of medical examination:
Signature
Seal: - Designation _____________________
- 83 -
- 84 -
- 85 -
- 86 -
Part- II
Medico-legal Articles
- 87 -
Photographs
I. Post-mortem lividity
1. Identify the photograph- _______________________________________________________

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Medicolegal Importance (MLI)- _________________________________________________
___________________________________________________________________________
___________________________________________________________________________
II. Decomposition changes-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 88 -
III. Decomposition changes-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
IV. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 89 -
V. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
VI. Injury

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 90 -
VII. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
VIII. Injury

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 91 -
IX. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
X. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 92 -
XI. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XII. Injury and identification-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 93 -
XIII. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XIV. Injury-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 94 -
XV. Asphyxia-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XVI.

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 95 -
Asphyxia-

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XVII.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 96 -
XVIII.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XIX.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 97 -
XX.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XXI.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 98 -
XXII.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
XXIII.
Paste

___________________________________________________________________________
2. Observations- _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
- 99 -
Museum Specimens
Sr. Identification / Medicolegal
Observation
No. Opinion Importance
1
- 100 -
Observation
6
10
- 101 -
Observation
11
12
13
14
15
- 102 -
Observation
16
17
18
19
20
- 103 -
Instruments
Sr.
Identification Medico-legal Significance / Uses
No.
1
- 104 -
Sr. Identification Medico-legal Significance / Uses
No.
6
10
- 105 -
Sr.
No.
11
12
13
14
15
- 106 -
Sr.
No.
16
17
18
19
20
- 107 -
X-Rays
1.
Describe X-Ray: ____________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: __________________________________
_________________________________________
_________________________________________
2.
Describe X-Ray: ___________________________
________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
________________________________________
3. Describe X-Ray: ___________________________

_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
- 108 -
4.
Describe X-Ray: ___________________________
________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
________________________________________
5.
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
6.
Describe X-Ray: ___________________________
________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
________________________________________
- 109 -
7.
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
8.
Describe X-Ray: ___________________________
________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
_______________________________________
9.
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
- 110 -
10 Describe X-Ray: ___________________________
________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
_______________________________________
11
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
12 Describe X-Ray: ___________________________

________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
_______________________________________
- 111 -
13
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
14 Describe X-Ray: ___________________________

________________________________________
________________________________________
Observation: _____________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Opinion: _________________________________
________________________________________
_______________________________________
15
Describe X-Ray: ___________________________
_________________________________________
_________________________________________
Observation: ______________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Opinion: _________________________________
_________________________________________
_________________________________________
- 112 -
Paste
Paste
Paste
- 113 -
Paste
Paste
Paste
- 114 -
Poisons
Madar (Calotropis Gigantea)
Yellow Oleander Plant

(Cerbera Thevetia)
Pink Kaner (Nerium Odorum)
- 115 -
Millipede
Castor Plant (Ricinus Communis)

with fruits
Castor Seeds (Ricinus Communis)
- 116 -
Ratti /Gunja seeds
(Abrus Precatorius)
Chilli seeds (Capsicum annum)
Marking Nuts/ Bhilawa

(Semecarpus anacardium)
- 117 -
Nux Vomica (Strychnine)
Tobacco (Nicotiana Tabacum)
Datura Seeds
- 118 -
Bitter Almonds
Copper Sulphate Crystals
Aluminium Phosphide
(Celphos)
- 119 -
Poppy Seeds (Khaskhas)
Lead tetroxide (Sindur)
Alcohol (Ethanol)
- 120 -
- 121 -
Study of Common Poisons of Medico-legal Importance
Sr. Name of Type of Fatal
Physical Characters Salient Clinical Features
No. Poison Poison Dose
1 Sulphuric
Acid
2 Nitric Acid
3 Hydrochloric
acid
4 Carbolic
Acid (Phenol)
- 122 -
Fatal
Treatment Post-mortem Features Medicolegal Significance
Period
- 123 -
5 Oxalic Acid
6 Sodium
Hydroxide
7 Potassium
Hydroxide
8 Phosphorus
- 124 -
Fatal
Period
- 125 -
9 Lead
Oxide
10 Arsenic
Oxide
11 Mercuric
Sulphide
12 Copper
Sulphate
- 126 -
Fatal
Period
- 127 -
13 Glass
Powder
14 Castor
Seeds
(Ricinus
Communis
15 Croton
Seeds
(Croton
Tiglium)
16 Red
chillies
(Capsicum
annum)
- 128 -
Fatal
Period
- 129 -
17 Marking
Nut/ Bhilwa
(Semicarpus
Anacardium)
18 Madar
(Calotropis
Gigantea)
19 Ratti
/Gunja
(Abrus
Precotorius)
20 Dhatura
(Thorn
apple)
- 130 -
Fatal
Period
- 131 -
21 Bhang/
Ganja
(Canabis
Indica)
22 Opium/
Afeem
(Papaver
Somniferum)
23 Bitter
Almond
(Hydrocynic
acid)
24 Aconite
(Mitha
Jahar)
- 132 -
Fatal
Period
- 133 -
25 Yellow
Oleander
(Cerebra
Thevecia)
26 Nux
Vomica
(Strychnine)
27 Snakes:
Cobra
28 Snakes:
Krait
- 134 -
Fatal
Period
- 135 -
29 Snakes:
Viper
30 Scorpion
31 Honey
bees
(sting Bite)
32 Methyl
Alcohol
- 136 -
Fatal
Period
- 137 -
33 Kerosene
34 Barbaturates
35 Organopho-
sphorus
compound
(Follidon
& Tik-20)
36 Organo-
chloro
compound
(D.D.T.)
- 138 -
Fatal
Period
- 139 -
37 Organo-
chloro
compound
(Endrine)
38 Carbamates
(Carbaryl)
39 Tobacco
(Nicotiana
Tobacum)
40 Tincture
Iodine
- 140 -
Fatal
Period
- 141 -
41 Celphos/
Alphos
(Aluminium
Phosphide)
42 Amphetamines
/Ecstacy /
Designer drug
43 Cocaine
(Erythroxylum
coca)
44 Mushrooms
(Amanita
Phalloides &
Amanita
Muscaria)
- 142 -
Fatal
Period
- 143 -
45 Paracetamol
(Acetamino-
phen)
46 Fish
Poisoning
47 Mother-in -
law’s tongue
(Dumbcane)
Dieffenbachia
Snake plant
(common)
48
- 144 -
Fatal
Period
- 145 -
49
50
51
52
- 146 -
Fatal
Period
- 147 -
- 148 -
Part- III
Medico-legal Autopsy
- 149 -
- 150 -
Medico-legal Autopsies observed by students
Sr. P.M. No./ Year
Cause of Death Signature
No. Date
1 /
2 /
3 /
4 /
5 /
6 /
7 /
8 /
9 /
10 /
11 /
12 /
13 /
14 /
15 /
- 151 -
- 152 -
.
Indoor/Casualty no: PM No:

Hospital: ADR No.:
Police station:
Memorandum of a Post-mortem Examination held at _____________________ Hospital on the body
of Name , Age- Yrs, Sex , Religion
of village/City: Taluka: District:
by Dr /______________________________ Hospital _____________.
I. General Particulars: -
1. (a) By whom was the corpse sent?
(b) Name of place from which sent.
(c) Distance of place from which sent.
2. By whom was the corpse brought?
3. By whom identified? i.
ii
4. (a) The date, hour and minute of its receipt.
(b)The date, hour and minute of beginning
of post mortem Examination
(c)The date, hour and minute of ending
of postmortem examination.
5. Substance of accompanying report from
police office or magistrate, together
with the date of death, if known.
Supposed cause of death or
reason, for examination.
6. If not examined at dispensary or hospital-
(a) Name of place where examined -
(b) Distance from Dispensary or hospital.
(c) Reason why the body was not sent to the
dispensary or hospital.
II. External Examination: -
7. Sex, apparent age, race or caste,
Description of clothes and of ornaments
on the body.
8. Condition of the clothes –
Whether wet with water, stained with blood
or soiled with vomit or faecal matter.
9. Special marks on the skin such as scars,
tattooing etc, any malformations
peculiarities or other marks of identification.
State of the teeth.
In newly-born infants: -
The length and (if possible), the weight of the
body is to be recorded together with the state of
the hair, nails and umbilical cord, its length,
whether placenta is attached or not, and if
present, its size and condition.
10. Condition of Body- Whether well nourished,
thin or emaciated warm or cold.
11. Rigor Mortis- Well-marked, slight or absent
whether present
- 153 -
12. Extent and signs of decomposition,
presence or post-mortem lividity of
buttocks, loins, back and things or any
other part. Whether bullae present and the
nature of the it contains fluid, condition of
the cuticle.
13. Feature- Whether natural or swollen, state
of eyes, position of tongue; nature of fluid
(if any) oozing from mouth, nostrils or ears.
14. Conditions of skin etc.
In suspected drowning the presence or
absence of cutes anserine is to be noted.
15. Injuries to external genitals.
Indication of purging.
16. Position of limbs- Especially of arms and of

Fingers or on the skin of hands and feet.
17. Surface wounds, and injuries- Their nature,

position, dimensions(measured) and
directions to be accurately stated- their
probable age and causes to be noted.
If bruises be present, what is the condition
of the subcutaneous tissues?
(N.B- When injuries are numerous and
cannot be mentioned within the space
available they should be mentioned on a
separate paper which should be signed.)
18. Other injuries discovered by external

examination or palpation of fractures etc.
18a. Can you say definitely that the injuries
shown against serial nos. 17 and 18
are ante-mortem injuries?
III. Internal Examination: -

19. Head: -
(i) Injuries under the scalp and their nature.
(ii) Skull: vault and base-describe fractures

their sites, dimensions, direction etc.
(iii) Brain: The appearance of its Coverings,

size, weight and general condition of the organ
itself and any abnormality found in its
examination to be carefully noted.
- 154 -
20. Thorax: -
(a) Walls, ribs, cartilages
(b) Pleura
(c) Larynx, Trachea and bronchi
(d) Right Lung with weight
(e) Left Lung with weight
(f) Pericardium
(g) Heart with weight
(h) Large vessels

(i) Additional remarks
21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(d) Buccal cavity, teeth, tongue and pharynx-
(e) Oesophagus-
(f) Stomach and its contents-
(g) Small intestine and its contents-

(h) Large intestine and its contents-
(i) Liver and gall bladder with weight-
(j) Pancreas and suprarenals-

(k) Spleen with weight.
(l) Kidneys with weights
(m) Bladder-
(o) Organ of generation-
(p) Additional remarks with, wherever possible,

Medical Officer’s deduction from the state of
contents of the stomach as to the time of death
and last meal.
(q) State which viscera, (if any) have been

retained for chemical examination and also
quote the numbers on the bottles containing
the same-
- 155 -
22. Spine and spinal cord-
23. a) Whether the ante-mortem injuries
found on the dead body were sufficient
in the ordinary course of nature to
cause death?
(b) If yes, which of the injuries were
individually sufficient in the ordinary
course of nature to cause death?
(c) Which of the injuries collectively
are sufficient in the ordinary course
of nature to cause death?
Opinion as to the probable/Final cause of death: -
Sign
Name of Doctor and seal
PM no:
Dated:
*The spinal cord need not be examined unless there are any indications of disease, strychnine poisoning or injury.
Note: - The report must be written and signed immediately after the examination. Medical officers will at once
dispatch a duplicate copy to the Civil Surgeon of their district for in his office.
Great care should be taken not to cut viscera before they have been inspected in Situ.
Post Mortem No. :- , Dated:

1. Place:
Forwarded to the , P.S. for information with reference to his No. / of Dated: .
2. Viscera has been/ not been preserved.
Sign
PM no:
Dated:
- 156 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 157 -
the cuticle.




19. Head: -


- 158 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 159 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 160 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 161 -
the cuticle.




19. Head: -


- 162 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 163 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 164 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 165 -
the cuticle.




19. Head: -


- 166 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 167 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 168 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 169 -
the cuticle.




19. Head: -


- 170 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 171 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 172 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 173 -
the cuticle.




19. Head: -


- 174 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 175 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 176 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 177 -
the cuticle.




19. Head: -


- 178 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 179 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 180 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 181 -
the cuticle.




19. Head: -


- 182 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 183 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 184 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 185 -
the cuticle.




19. Head: -


- 186 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 187 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 188 -
.

Hospital: ADR No.:
Police station:
by Dr /______________________________ Hospital _____________.
ii
on the body.
State of the teeth.
whether present
- 189 -
the cuticle.




19. Head: -


- 190 -
20. Thorax: -
(b) Pleura
(f) Pericardium
(h) Large vessels

21. Abdomen: -
(a) Walls -
(b) Peritoneum -
(c) Cavity-
(e) Oesophagus-


(m) Bladder-

and last meal.

the same-
- 191 -
cause death?
Sign
PM no:
Dated:

1. Place:
Sign
PM no:
Dated:
- 192 -
Part- IV
Common Medico-legal proforma routinely used in medico-legal
Practice
- 193 -
- 194 -
C.M. 23 m. & e.
Form in which to report post mortem examination to be used when forwarding

Viscera to the Chemical Analyser
From:
TO
THE CHEMICAL ANALYSER TO GOVERNMENT
OF MAHARASHTRA, ___________________
_________________________________________________________________ Date: ________
Description of Viscera forwarded for examination:
Mode of packing: Copy of the label attached to bottle
Box No. Bottle No.

Impression of
Weight of parcel
Seal
Mode of dispatch Date of Dispatch
Information furnished by police officer or precis of case :
Name: Sex: Age: Caste:
Thana or village:
Story of the case -
- 195 -
Date and hour of dispatch of Date and hour of autopsy Names of officer by whom
body Examination was actually made
Date of receipt
Appearance of Body –
Muscularity: Stout: Emaciated:
Special Marks:-
Scars: Tattooing: Amount of Hairs etc.
Signs of decomposition:-
_____________________________________________________________________________________________
Wounds and bruises:
(a) Position: (b) Character: (c) Size:
_____________________________________________________________________________________________
State of natural orifices:
Nostrils: Mouth: Vagina:
Anus: Urethra:
State of limbs etc.

Rigor mortis: Position:
Contents of hands if clenched:
Relaxed
Feature
Contracted
Eyelids: Pupils: Contents of mouth:

Position of tongue: State of teeth:
Thorax -
Ribs: Cartilages: Pleura: Pericardium:
Heart: Shape and appearance

Cavities
Clots ante or post-mortem
Muscular structure
- 196 -
Vessels: Clots
Aneurysm
Atheroma
Lungs : Appearance
Colour
Consistence
Adhesions
Larynx, trachea and bronchi for foreign bodies or disease:
Abdomen: -
Peritoneum
Peritoneal cavity, contents
Liver and gall bladder -form and size, disease or injury
Pancreas disease or injury
Spleen disease or injury
Kidney disease or injury
Stomach Size and general appearance

Appearance of coats
Contents, appearance, odour and quantity.
Intestine Size and general appearance

Appearance of coats
General Organs: -
Bladder and contents
Uterus appearance, size and contents
Vagina, contents
- 197 -
Head:
Scalp
Bones, Disease or Injury
Membranes
Brain substance and ventricles
Base of skull fracture, caries, extravasations, etc.
The Spinal cord need not be examined unless any indication of disease or injury exists.
_________________________________________________________________________________________________
Fracture and dislocation
More detailed description of injury or disease
Opinion as to the cause of death: -
Station
Date Civil Surgeon / Medical Officer in Charge / Autopsy Surgeon
- 198 -
C.M.24 m. e.
Form No II
Form or report to be used when forwarding substance

Other than viscera to the chemical analyser
From:
To
THE CHEMICAL ANALYSER
GOVERNMENT OF MAHARASHTRA,
________________________________
Dated: / /
Forwarding the article mentioned below for examination for ______________________________

___________________ In connection with the case of___________________________________
---------------------------------------------------------------------------------------------------------------------------
Description of Articles
Mode of packing and weight of parcel Copy of the label attached to bottle
If standard boxes and bottles are used
a) Box No. b) Bottle No.
Mode of Dispatch Date Date of receipt in Chemical Analyzer’s office
Date:
Facts of Medico legal importance in connection with case:
Station
Date Civil Surgeon / Medical Officer in Charge / Autopsy Surgeon
- 199 -
- 200 -
Form for Dispatch of Viscera for Histopathological Examination
TO,
HOD / In-charge,
Histopathology Section,
Department of Pathology,
___________________________________, _____________________ .
(Through: _________________________________________________)
Subject : Regarding Histopathological examination and report.
Reference : MLPM No.________________________ Date: _____________
Name of deceased: ____________________________________
Age: ___________ Sex: ______________
Hospital Reg./MLC No_______________ Ward: ____________
DOA & Time _______________ DOD & Time _____________
Nature Of specimen:
Preservative Used:
Clinical Details:
Clinical Diagnosis:
Autopsy findings in brief:
Probable cause of death on Autopsy:

Special instruction, if any: -
Place: Signature
Date & Time: Name of Doctor
Designation & seal
- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - -
Histopathology Examination Bottle No. 1
Name of the Hospital: ________________________________________________________________
P.M. No: _________________________________________Date: _____________________________
Name of Deceased: __________________________________________________________________
Police Station: ______________________________________________________________________
Nature of Specimen: _________________________________________________________________
___________________________________________________________________________________
Preservative Used: ___________________________________________
Date: _____________ Autopsy Surgeon
Place: ____________ Sign & seal
- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - -
- 201 -
Labels for Viscera Bottles
Bottle No. 1
P.M. No: _________________________________________Date: _____________________________
Name of Deceased: __________________________________________________________________
Police Station: ______________________________________________________________________
Preservative Used: ________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - -
Bottle No. 2
P.M. No: _________________________________________Date: _____________________________
Name of Deceased: __________________________________________________________________
Police Station: ______________________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - -
Bottle No. 3
P.M. No: _________________________________________Date: _____________________________
Name of Deceased: __________________________________________________________________
Police Station: ______________________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - -
Bottle No. 4
P.M. No: _________________________________________Date: _____________________________
Name of Deceased: __________________________________________________________________
Police Station: ______________________________________________________________________
Sample Preservative Used: ____________________________________________________________
- 202 -
Instructions for Forwarding Blood/Tissue
For DNA Fingerprinting/ Paternity Testing.
1. Medical officer should collect fresh blood in 2 ml plastic tubes (2 blood samples from
each person) provided by Regional Forensic Science Laboratory.
2. Please shake the tube for 7-8 times after collecting blood.
3. Duly labelled tube should be kept in sterile plastic bottle which should be immediately
sealed.
4. Duly filled IDENTIFICATION FORM should be sent along with the sample.
5. COPY OF SEAL should be provided at the end of IDENTIFICATION FORM.
6. For each person, a separate IDENTIFICATION FORM should be filled by Medical

Officer while forwarding samples for DNA profiling.
7. Photograph of person on IDENTIFICATION FORM should be duly signed and attested

by the Medical Officer.
8. IDENTIFICATION FORM should be signed by Witnesses in front of Medical Officer.
9. The samples should be sent to the Regional Forensic Science Laboratory in ice box with
ice, if more than 4 Hours are required to submit the samples.
10. Products of abortion/ other tissue should be sealed in a sterile plastic bottle and sent to
the Regional Forensic Science Laboratory in ice box with ice. If available, 4% EDTA
could be used as preservative.
11. Don’t use formalin or other preservatives. Formalin preserved samples are considered
unacceptable/ inappropriate for DNA analysis by Forensic Science Laboratories.
12. In case of blood transfusion to donor within last three months, blood sample should not
be collected. In such case, donor’s blood sample should be collected after four months
of blood transfusion.
- 203 -
Identification form for forwarding samples for DNA Fingerprinting/ Profiling
To
Prefix
Deputy Director,
photograph.
Regional Forensic Science Laboratory,
State of Maharashtra, __________________. Photograph to be
attested by
Medical Officer
IDENTIFICATION FORM
Name : _________________________________________________________________________
Age: _____________Sex: ___________
Father’s / Husband’s / Guardian’s Name :________________________________________________
Address (with Tel. No. Fax. If any):____________________________________________________
Description of sample : _____________________________________________________________
Genetic abnormalities, if any (specify): ________________________________________________
Date and Time of Sample collection :- Date:______________ Time:_____________________
Forwarded by:
(a) Hon’ble Court of / Police Station :_______________________________________________
(b) C. R. No. /FIR/Case /MC/OP No., etc. : ___________________________________________
--------------------------------------------------------------------------------------------------------------------------
DECLARATION BY DONOR
(OR BY GUARDIAN IN CASE OF MINOR DONOR)
I, __________________________________________________hereby declare that the blood given by

me / my ward to Regional Forensic Science Laboratory, State of Maharashtra, __________________
is with my consent and I / my ward did not receive a blood transfusion within last three months.
(Subject/Guardian)
The blood is collected in presence of following witnesses:
(1) Name: ______________________________________Signature: ___________________
(2) Name: ______________________________________Signature: ___________________
Copy of Seal
Sign. and designation of M.O. with Stamp
• STRIKE OUT WHICHEVER NOT APPLICABLE,

• IN CASE OF BLOOD TRANSFUSION TO DONOR WITHIN LAST THREE MONTHS,
BLOOD SAMPLE SHOULD NOT BE COLLECTED.
• PASSPORT SIZE PHOTOGRAPH TO BE ATTESTED BY MEDICAL OFFICER.
- 204 -
Summons to Witness
In the District & Sessions Court

At
Session Case No. __________of 20
Summon to witness
To,
Whereas complaint has been made before me that_________________________________________
Of ______________________________________________________________________________
has committed the offence of _________________________________________________________
on or above the _____________________day of ________________20____at _________________
and it appears to me that you are likely to give material evidence for the _______________________
You are hereby summoned to appear before this court on the ______________day _______________
at____________ hours to_____________________________________________________________
testify what you know concerning the matter of the said complaint, and not to depart thence, without
leave of the court, and you are hereby warned that if you shall, without just excuse neglect or refuse
to appear at the said time and place a warrant will be issued to compel your attendance.
Given under my hand and the seal of the court this ______________day of _________20______
Superintendent
(By order of Session Judge)
- 205 -
- 206 -

Second MBBS FMT Syllabus 030621

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Course Content

FORENSIC MEDICINE AND TOXICOLOGY

5. Topic wise distribution

1. Total Teaching hours : 50

Topic: General Information

2.17, 2.18 autopsies in cases of death in custody or following violation of Integrated

to Phosphorus, Iodine, Barium

iv .N arcotic Analgesics, Anaesthetics, and Muscle Relaxants

Skills in Forensic Medicine & Toxicology

FM 3.27 Define, classify and discuss abortion, methods of

FM Forensic Laboratory investigation in medical legal practice

I-Exam (After 3 months from start of II

I-Exam (After 3 months from start of

6. Conversion Formula for calculation of marks in internal assessment examinations

Internal Assessment Marks Final rounded marks

Theory Internal Assessment Pattern

Practical Internal Assessment Pattern

Paper Section Topics

Subject: Forensic Medicine & Toxicology

Subject: Forensic Medicine & Toxicology

Practical Oral/ Viva Total

1. Course and : MBBS –PHASE III Part -I 2. Subject Code :

Instructions: SECTION “A” MCQ

SECTION “A” MCQ (20 Marks)

SECTION “B” & “C”

Instructions: 1) Use blue/black ball point pen only.

SECTION “B” ( 40 Marks )

SECTION “C” ( 40Marks)

5. Long Answer Questions (Any 1 out of 2 ) (1x10=10)

FORENSIC MEDICINE AND TOXICOLOGYLOGBOOK for

First Edition: 2021

Admission Year: ____________

Teacher In-charge Professor and Head

* AETCOM – Competencies for IMG, 2018, Medical Council of India.

Competency Name of Date Attempt Rating Decision Initial Feedbac

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

 What next? (What knowledge or skills do you need to develop so that

Signature of Teacher-in- charge

 So what? (What are the applications of this learning)

during the session from __ to _ and

Spacing behind second molar- _ Abnormality if any-___________________

D. Radiological Examination: Reference: x-ray plate no._____________ Date- _

Spacing behind second molar- _ Abnormality if any-___________________

D. Radiological Examination: Reference: x-ray plate no._____________ Date- _

Certified that Shri/Smt/Kum_________S/W/D of Shri

Certified that Shri/Smt/Kum_________S/W/D of Shri