Schedule-15 (Relating to sub-section (5) of Section 20) Autopsy Report

Schedule-15

(Relating to sub-section (5) of Section 20)

Autopsy Report

1) Case registration number:

2) Police office sending for autopsy (letter date and reference number):

3) Name of the deceased:

4) Address:

5) Gender:

6) Age, date of birth:

7) Dead body identified by:

8) Name of the accompanying police personnel:

9) Date and time of death:

10) Date and hour of receipt of inquest papers and dead body:

11) Date and hour of starting autopsy:

12) Date and hour of concluding autopsy:

13) Name of the experts conducting autopsy:

a. ……………. c.…………….

b. ……………. d.………………

14) Name of the Hospital:

Relevant details (mention brief history of the case regarding circumstances of death and other sources of information):

External Examination (general observation of the dead body):

(1) Height

(2) Weight

(3) Physique:

(4) Hairs

(5) Clothes and conditions:

(6) Special identifying features (Huliya):

(7) Postmortem changes present:

(a) Rigor mortis:

(b) Livor mortis:

(c) Algor mortis/cooling:

(d) Different signs of decomposition:

(8) Natural orifices:

Eyes   Mouth    Vagina/penis

Nose   Ears       Anus

Urethra

(9) Injuries: Name, size, and site (Ante mortem/postmortem/old/fresh)

INTERNAL EXAMINATION

Head and Neck:

1) Scalp, skull:

2) Brain and vessels:

3) Orbital, nasal and aural cavities:

4) Mouth, tongue:

5) Neck (larynx, thyroid and other neck structure:

6) Other relevant details

Chest (Thorax)

1) Ribs and chest wall:

2) Diaphragm:

3) Oesophagus:

4) Trachea and bronchi:

5) Pleural activities:

6) Lungs:

7) Heart and pericardial sac (any content in pericardial sac, condition of three coronary arteries, valves and chambers and myocardium must be observed):

Abdomen

1) Peritoneal and pelvic cavity:

2) Stomach intestine:

3) Small intestine:

4) Large intestine: Spleen:

5) Liver, gall bladder, pancreas:

6) Spleen

7) Kidney, renal pelvis:

8) Genital organs:

9) Urinary bladder and urethra:

Spinal Column:

Specimen collected for analysis (mention preservative also):

Toxicology:

(1) Stomach with contents:

(2) Part of liver:

(3) Kidney:

(4) Blood:

(5) Others, if any:

Histopathology:

Others (specify):

Special Examination: (Procedures like neck dissection, pelvic dissection, flotation test of lungs etc. must be done in relevant cases and findings should be documented):

Items handed over (when and who received?)

(1) Autopsy report:

(2) Viscera and other samples:

(3) Clothes and other articles:

Opinion or conclusion

1) Opinion or cause of death:

(Mention cause of death in Nepali language also)

2) Opinion on time since death:

3) Opinion on probable type of objects or weapon causing injuries:

4) Opinion on live birth or still birth:

5) Other opinion, if any:

Signature of Medical Officer/Expert

1.	2.	3.
Signature: Date:	Signature: Date:	Signature: Date:
Name: Special qualification: Training and experience: NMC Reg. No.	Name: Special qualification: Training and experience: NMC Reg. No.	Name: Special qualification: Training and experience: NMC Reg. No.

 

Seal of the Hospital:

Date:

Note bene:

1) Postmortem shall be conducted by a forensic expert, to the extent possible, and by a trained doctor if such expert is not available.

2) The report shall be prepared by the autopsy conducting expert or doctor himself or herself.

3) The report shall be computer typed to the extent possible, if not so, be prepared in a legible manner. In addition, the original of the autopsy report shall be attached.

4) If the specified space is not enough to contain the details, details shall also be set down in a separate sheet as well.