y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_ajani_m6rj.pdf · first information...

19
'Y- '!- FORM COMP AA s, S ee Ruls 253 (c),25a (c) (iii),254 (S),2 55 (l) (iv) A P) AV qREffiq ftfrFn, srwfi qMq €qTq Eqqr yr. 6€sr+\ a Dee l(uls z>Jlc) rzJ4(cxln),2)4(U),255(I)(iv) A REPORT ABOUT THE MOTAR VEIICLES ACCID4NTS rq *t $ Ri$ W* 3rwq1 rTrS{ ate{ Wt.o.q 6orl io3/ts SOq 1\e3 i?\e ,ioY 3T qTqm 3Tqqrr m'. da oQ/11/qs q ts.?o ET E{ql;I 3lrf€1-f, fuffiTuI aepfiq *fo* qrffi qlis q{ sn-+ir +'n q}.€. srqfr X ^\ qElfl/Tfimfq {l4 q q(nT 3nfuq WRrr Fq-{-il qq R/ rt. €Rrtg{ M q q-grfiu rrq'fl q:+ sqqR i-d-dcqT drffi qq \^ qgT-s-o 6t|sr50 i'frlT{ qfd{I.lt T,iR 3TTITI 9rF1-{ te\.-----------\- !]W OT|{=l S]-EI 55 srqnFTl Tgzikl Ts@rq w qrd=r qoffia ilq q q"i q-.f,r q|il'T I{{EHI STIT-S' qrf,{ !'qqitT m fiqfoq i fTT 'ilY a 3rlqn ffii qr-Aq ql,o-sTi T{q q qdl f+'{R -q) TG.w{ q"gq{ 6JqR wr Yq l)vqq fuq-{ frt q'q YY 3 3rwrd qrd-{ri frqT fiqufri qTq q ftqTTfrq qqioqqr gdT R g $*-qT -; F'- ,,Y-, ,f! qp t(".9ll(,$l {o \^ 3flrnf, Erf,rTq RqT +fl rr} ll e) qtoQc\e3o F*- lq q I t,1q ,/ 9ltl'l v lq q I \/./ qu d il/Ro/ls q?, {K{ 3Tqgl-fl !-s-iutrfl' e,BidT6l qqt rorun-n' 3Tr-tq1 frN< UET qTc'o 6qa 3ndq}q o-s-q Aqtfu wt qfq-roqkr qK{ s{u-qrf, oil-d . 3IEF

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Page 1: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

'Y-

'!-FORM COMP AA

s, S ee Ruls 253 (c),25a (c) (iii),254 (S),2 55 (l) (iv) A

P)AVqREffiq ftfrFn,

srwfi qMq €qTq Eqqr yr.

6€sr+\ a Dee l(uls z>Jlc) rzJ4(cxln),2)4(U),255(I)(iv) AREPORT ABOUT THE MOTAR VEIICLES ACCID4NTSrq

*t

$Ri$W* 3rwq1 rTrS{ ate{

Wt.o.q 6orl io3/ts SOq 1\e3 i?\e ,ioY 3T qTqm

3Tqqrr m'. da oQ/11/qs q ts.?o ET E{ql;I3lrf€1-f, fuffiTuI aepfiq *fo* qrffi qlis q{ sn-+ir +'n q}.€. srqfr

X ^\qElfl/Tfimfq {l4 q q(nT 3nfuq WRrr Fq-{-il qq R/ rt. €Rrtg{ Mq q-grfiu rrq'fl q:+ sqqR i-d-dcqT

drffi qq

\^qgT-s-o 6t|sr50 i'frlT{

qfd{I.lt T,iR 3TTITI 9rF1-{te\.-----------\-

!]W OT|{=l S]-EI 55 srqnFTl Tgzikl Ts@rq

w qrd=r qoffia ilq q q"i q-.f,r

q|il'T I{{EHI STIT-S'

qrf,{ !'qqitT m fiqfoq ifTT'ilY

a 3rlqn ffii qr-Aq ql,o-sTi

T{q q qdlf+'{R -q) TG.w{ q"gq{ 6JqR wr Yq

l)vqq fuq-{ frt q'q YY

3 3rwrd qrd-{ri frqT fiqufriqTq q ftqTTfrq qqioqqrgdT

R g $*-qT -; F'- ,,Y-, ,f!qp t(".9ll(,$l

{o\^3flrnf, Erf,rTq RqT +fl rr}

ll e) qtoQc\e3oF*-lq q I t,1q ,/ 9ltl'l v lq q

I \/./ qu d il/Ro/lsq?, {K{ 3Tqgl-fl !-s-iutrfl'

e,BidT6l

qqt rorun-n' 3Tr-tq1 frN< UET qTc'o 6qa 3ndq}q

o-s-q Aqtfu wt qfq-roqkr qK{ s{u-qrf, oil-d .

3IEF

Page 2: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

FIRST INFORMATION REPORT(Under Section 154 Cr.p.C,)

sPlc {{{T Rqtd(qnr 154 es sfhziT slear b creat

1. District (G-ar):Tqgl {r6i

FrR No. {c.{.ft. €.):06s2 . 30 3 lls- P's' (afl'rr):3fs* Year (qri): 2017

z. '_S.r.ro. (ir.ri.)f Acti-(Jtfqfqrt) - - - - -*-.--.-^,- Dat€ and rime of FtR (q.*R. f R+6 3ih 06l:.y2017 23:29 q-S

. _,'j"'jffia;- --_-_-------__--,;;;'"nL:sru---_ :,__,_*._____-__-:_-__- _,

1. Day (fr{):riqER h_r- F..' Time period (srq o-ofEf;; u5q 6

Date From (frrT-6 t I 06/1112017 Date To ( friio a-o ,to6/7ll2ot7(b)lnformatior,.".",rr"ol.;" ,,_ #_

TimeFrom(qcq*):rz:go{d TimeTo(virrrirrr):17:30*$

(c) Generar "" **:::;'"i#H iH::Hi*T; 0"""0'Ju." & rime .#.[H'ujfrlro!"rr 23:15 {$4. Type of Informatibn.(qc+r or rFDIi): oral

' !"rE trearq' qr\ s

5. Flace of Occurrence- (Erd;IFer€)l

' ::i::"'=;:i#i$"#h1.ffi,gyyftsrlEftq, o: bd BeatNo. (*ed.),

t"-'Jn'':;'":::,'ff *'#S"r this porice station, then (qR aIray qftqr b sr6* * nl):' District(State, (fudr nrrig{ 9Er(T6.mT}

6. Comptainant / Informant (faT6rqirsdrqq-{rm-df }:(a) Name (lFr): *6q-6$3q{or_+rd qq21q{

(t, ffi.Ht#,"usband's Name(aslq 7

(c) Date/Year of Birth (q=q ftf* I sq ): f SgO(e) utD No. (q3nf$ €of.(f) Passport No,(qrff+d

Place of lssue (qR1 6_{i 6.I TeJ|{ }.(g) ld details (Rafion Cal

s. No. ( F.€. r,,o rro.i?rff;:tff,"'*port, u r D No., Drivins

. 1 : : -. ..... . : !d Number (qffi"r sg4r)(h) Address (r{tfr): :

(d ) Nationality ({r$q-rr) r lrlTd

Date of lssue (qrt1 qt{i ff

6.tT.)

(i) Occupation (a4q-.-rq): "r3\ 'svar 'rrrrgt sr6{.q6|tl{,qlrfl

(j) Phone number ({srns q.):7' Details of knovvn/suspected/unknown accused

Mobile (qiirFcI q.):

{1$tr-flagry1ryn*l-"$;#Sff wrth rulr particurars (srd / dtuq t rsn crft'gm or qt fc-d-rur efta ed-13

ftft{{ €erq sfiilftqHgr {rfr.

i--r-l@--- eE;TffiFq-drr--

Page 3: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

N.c. H,.F t V.r.rft . 3rR.d1:l.l.F.-l (GlgR qrq ffi--

4l Tin : qg6r EeqR 1. rne F107{i'iir Trll 3ir*1E qq,.i'tgq,,il5i 916r.'r6RIg,rI{C

a. Reasons for delay in reporting by the comptainant/informant tRrorqiffdi/ qnr.r6df crrr ld€ tA i <d _ol i b _,r*),9. Particulars of properties of interest (ri<C!*R {rcR.or fi-{<ol):

L!:[t:_tri]-T::Ei-t_:_!:g:?_f$ ffi-i-Fropertv-iyp{t-(s"trn-irr --lb;#ipiio;"Tftsi,r, ..*-**--] %iudi in nil:)- (wq to I10.Tctal value of property (tn Rs/-)-qcqR or g-e Wqt;iii,

-_,i'*.."a, i_l ! : l"F*")11.Inquest Report / U,D. case No., tf any (fg v*er itqt€ I {.3l,s-rrq Ti., rTR oH A} l,

j5.No. (#.ri.)lUiba ilumber i(d)"i-ffi ji.i

First Information contents (HW qaq gea ;;B-atsr 3{-d 3ni ff ql':ff-d qdm qin qeqlreid qcr.$+ frc W arwrn n ord-a en^i}ffi wrtrcerd g{{Ri qere{r q ildri iqdFTsBK{d dTT.TTt -s-^'"-tr< $rd q+s<.{ a 1 i'ar grorar +oso+i t qrsq ds,rd ard}o q4q tr 1q.d q-.u

6rrErR{ il{t.r F2q{q'} EruqRisdr snre i ofugo sT+i tqri E ,z g=ar _""jiiqt"iiji.;4ipt m#;x13".ffi .il"] r "

13. Action taken: Since the above information reveals commission of offence(s) uls as mentioned at ltem No. 2.(a'rd oFiqrs : '!fd sv*|o wr-6l-s t rr.l] qnFiTl d fo sry{rq an-ri or n-ttar r< €. z i+ s-aic s-rir } a-ea t lt11; Reeistered s",fiii 3$H*ih'$tlii- * shailesh sunir sankheo onspector))/ poBi.rs74or. or

(2) Directed (Name of l.O.) (qiE 3Tl*6n1 i5r tFr): Rank (qE):No.( 1i.): to take up the Investigation {o} qiq sici qr11 { d} b fa\ ft{q fr{r rprr) or (ql}(3) Refused investigation due to (qrq *'

or 1b'orwi 9on foql qrl

(41 Transferred to p.S,(qlrrr), Oistrict (&dT):

on point of jurisdiction (oi ffior< * orrq rserofta) .F'l'R' read over to the complainant / informant,a-dmitted to be correcfly recorded and e copy gaven to the[9#;i*"Stj inrormant rree or .o.i. iiffi / qe_rr+nf # ;;tEA'** -- E{rg qrft, wd ed g€ nn 3iq ro oi{ ft{wR.o.Ac.(qrt. eil.c .$.1

14. Signature/Thumb imnrelsion of the complainant / informant.t ltrorqr{idf I qa_**rf F r*-cren / ff

-; B-#d;" "

tt'3*E*ll time of dispatch to the court lorcraa ii nsq ff tu{i-6

fudqSignatur-e.of Officer in charge, police Station(e{rfl cqrrt * rwrefit

Name (irq):Shaitesh Sunil SankheRank(qg): I (lnspector)No.({i.): PoBNBT4ol

ffi

Page 4: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

Actan

Fornl : 2-A

CRIME DETAII.S FbRMT@rqr sq*=diTEfi cAtTi

.. .F. S. ..*,....O.. *year .-..........,. FtR fto. . .BoS ll..lq6s .o,,.\ 9utdf u6 bot? oe* **,.. Dare .d..l t ltl+

nix t(9

4.

3rh tD; 939; D4 a\;d"8

The Piace of Occurrence shown by :

qd+A ftorrT qre"hq-FqfA :

Name: ...,r..,............. a\ . Father's/Hr rql- n

;'''"' 4i;\'UiN' , 'SAibi,V Father's/Husband'sName : ...,r.\......sdtOt<\f n.qlt/ofin;.'"' " qro{tr s7id4rvAddress: -. - \ 'n ... .....:f . ..1 n n 11;,--" "ATdix$"t .1&"rliN : G"u"\i ala q\:t^a ;"1qir{8ui siinFf)

N, r$oo$ d\;s:TYPE OF CRIME (AtlinctucJing M. O. Crime) :

T@rqT s-+x (Xe n wi qqfr-s-e);

(i) .Major Head...'.$..^..........,.Q. (ii) .Minor Head:qq- eft{ p\C\l d 'Ae}ii

'"' ,i- ** .

() -;,il(*)3s, dssrs&

{iv)

ivj

.Jv€ iil

ivii) -SpeciailFeature-1 :

iTflil iiYi:e'dl-.1 .

" !:pr:i,":i Feaiure-3 :

ii,rrq tit-q=-3 :

6*"$; *1S0{\.&\

t:, :.;t1 ."Ottet ty !illrclr;:,1,_, i!"i,or1-,rg;: . . .

.., , . .,. r,i; it.Iii

ffisqlfiTfr&em+dir€mqs*

irrlg( Qr6t.

Page 5: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

F

Parliculai's of ihe viciims (Attacli selJarate sheet, if required) :

sdTaT cq-*l-ci (3rt-qrq-fi 3r{r€rmJ-r'Jrit o;irrq G\-sro) :

D.t;

iiame !

is----J,t!.tcq tq/

qlci

Yearoi Sirlh

c;cdtfig/..*icl r'!

(-4)

sex liI

'I

fuq ir

Beligiott

qd

WheinerA.dc!ress

'1 (.ri

Irvl

in-d}/ i G-ci{Tis,,,,. ar:1+llCl

@w

Descripiion of physicai evidence irom the scene of crir*ne {or the properiy recoveredi'selzed for the purpose oiinvestigation :

dqiw-mrq ueqat gqs-r EuF T€ral ulfEqr-n ffi"wricr< ddan .ncari-i wh:

1. Witnessrnei)hn

44

2. Witness Name: ....-;i-iq

:

Address:

t(lt .

t(,u a, s:4; aiw d^.8; 61i: qt ; '

(r) | i2)

Ynq \\\ 6-t*sAqTffi

ei+-d6aqj-.+

\',q,P

vDetails of pi'operlies Stolenl!nvol,,,eC ilJse appropriate presc:if'ecJ for.m (s) anC attach I'zi{i-qr I +in-{a rrmnqr ilyft,l (drn l-f<t qriir.l it rh,m ;iiercr)

X*"' %r<t.qA, ."roiieR ;ri Ao< c,r< '. gq-

.*\U'l

n.+t')N+xA' - '$'

P-rcs', &' .,ct'I -{N>: c-\-. '1

h ge;r,,+{ush .:i'

Page 6: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

f"f

if,"f

ifi .\J

?ats aitd tinie of visit to the place of oi;c:-;rrefice :

-.rsi.al q.Fl}qc Re-r* nrft-ts q A-d '

Descrlption '::i tfi* pl;ce a{ oi:rurrenc+: .

qet-:i;ltil-*'qrj;i :

Date...6l. I !.J.f+ rime..6;, \_.ol(|tn qco

Form: ?-C

\r 8.19o' 6i \$ lgo

-B&, -qqqq drrr<\S$w--eRftq-6N&HlRr - E!+ =-^e{<

+ "wprfr-

if n+eded. lflto scaie,

AZ4REFT

qrfi"urT-T{a{ ji-dd m er}\n^.-^.-.%\argaoFr{*{\I5

{ct{l\rlo1$r L

oidotqo\el

Signature of tffiiQation Officer with

nqmut 3{1ffi rrfr

c2 &+{ "r+ "i+

10. Sketch/lvtap af the piace cf occurrence rua.ttach Sketch/[4ap wiiir iegu:trct: ::ei:a,'ateiy,

indicaieso.MaybecerlifiedandsignedB.vwiinessess,ifrequi:.ecqeiqr 'crii ieffi--*iczr,Rir (rr-sq ?ilF@ts flft-frq-g W"nlr*i:ri cki*'d G6qTqrffi iilq{qrn 3l{fedlffl mei-s,niq gqTFrd q elan'to t61qfi +ga l'

....,'.

f&a'tE+tg-c-

slQA{ d*r,(+

3Nas

H'u' Ls\.dr\-. a"il,nFlant< ......).....\.,/..... Date: .......

qcqn bttti6t{td nd.Rg 61t tllT

iI=rl;{i.il dti-18 ttr.\ (.--,..,ii(--ti!.)..,',, r1qfl rfli;6t f g 'Ctri )nO a.: ' !j';-

Page 7: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

fi""'.u c,6i,,,,r$ rl*;F*6*ffi-R;il' -S<iin'rg,r .b%R,i a. .p,nu,-*ol,*}t #"q $ft# *aa

=qqTt*" -cet- B'wraqraf-d2ra & "*}.-qr *RR ai.-,sqrga'Fi\dqr\4-

-*ro-q-ts €!r,drr.e@ * -eru.F €-,R qz-ao*q-& -fia=t 1+* l"t* -v-i )t -q4"- +'-*;T;*c...?/ 566a -** -tr{-

ffiHt p-Qefor 6*"9 €rfr*r u& "* -w'9s"- 6rcq;r*:swmTffigrkqy,HtrffiHT:r-.--SzF -S- =n*s,o ** ** mr=ruW&r_

K\-q Jcg *r* g" r:,1i1-.ko-9- e-zg *+ E* "*i -.qA. -#-

A-mr zrqitqr qr$r:.i *;; =*,."=# *=*ofi$"tr-'rsF,{ k1\ a_--2'.*.3w *R. qu&.qr *,1"}g $eq**+;".q<i\l +cTcQi. ei.q* .?\nB aa'l miqafd{ 6pi, NeIil -Aie itn frl;:i -tl-*tr. uf*.*fu\ Q ** "ielR -*ary! *rr** -*$ u-{,. ";-*g; o{ {ffi ^

Tt'fu& . Aqo =r-qt$ rr*. - r; "S;*}pg* ,R#, ryt.p. }tdh*or' -erq{- *t$ryru\ ffi< *qI =* *"#.%u=< ar$q-<.r%%A{ =T* 5b* ri duuu)tr ;#.*ar a- ta"m} ',€#o\rW)*s6*b5kr gsr zr+za,S -+.a"8 ffi# ,.* =i+.,#?#)

=Ttt--

s':rs<- qea-?+b-rprurr$- aoft d+ **Fq.# RGaT

i'^),*[email protected],* .xi;rr art-{ sd ='\W*"Sar+*c'i''i n-"wiffi M:ls: af' ET (Rf11 gr*.0"r* top) d_{ ,S}4S{T/"ittvni .qi\- wts "firffi.

.eq*a.<"F,"€ -\itzt "Tb{

gr6rFe "{* "aE5ezr-qu-<,h_

s-q{ts"ur q,q- .'x<t\A-sqfr-qrn *.*B+rr + .S ;S" {6.s6-+

;fl "-*, qrofrnt- o, \a*;)rgr

"t2".*-u-"F8 .*r#qE' F'-Be !N -T{loT,

=q6:{ €p-atq-&f- s.tre}ar es- Fr EZa] o\s q-qB-{\d'-T ,L+,BZ <'ft.Ir sr*sE' 4Wt -A.'< G- *-- _S#

=,qq'*ri'eG \s-sz *-Q rt*ni =,*Tfr -u.-se q& os' --*, 6vzg - u: Trz mtq- -frd b#,' arfi frq.{ -a-Ea Erd-.-

ff- r4*.*y-n *rg-4* "ftSlq\'a^,?sA- "o "yL d*S-erffiffiar @\do' graplr

"t$ a\=qar =-s*e q.or-be'cp :y.o ,

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Page 8: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

" ' ii,i

:fltr qc< a{r wi@ fesr&*g5**#ff:Rffiffi*\ - :.\qvi -< :u\ ffi,*_Ed\*.*ffiH qlA+-q'#g'ffi

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X5.,W re\3o-eW)-.RNzT *Ndzr, =fo-n-+r az+trF N-<u- s-*qna firyd ft*\-wqtar r.'*t ftq.- "#b* :o .ffi auo{N\gd e-\f

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Page 9: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

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Page 10: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

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Page 11: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

:{*r 5$1yt $- -wfrw. ; rm& - l9'' iffic,asbl

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irqci a g.J iii;!.(q

(\'- kt> i46JL'Itffi)

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Page 12: Y-nagpurpolice.gov.in/media/accidents_compensation/309-2017_Ajani_M6RJ.pdf · FIRST INFORMATION REPORT (Under Section 154 Cr.p.C,) sPlc {{{T Rqtd (qnr 154 es sfhziT slear b creat

./4 lvs.-PA4-1 and

11-12-47,

Punaram lvanate

12:50 PM

01:45 PM

MLPM No. NTS/2341117

07t11t2017Maharashtra, Bombay's4-7-62.1

examination herd at Government Medicar coilege and Hospitar,Nagpur

or vllage sarangpur

City

,by Dr. N.T.Sharnagat

l. General Pafticulars-

1. (a) By whom was thecorpse sent?

(b) Name of place fromwhich sent.

(c) Distance of placefrom which sent.

2.' By whom was the corpsebror.rght?

3. By whom identified?

4. The, date, hour andminute of its receipl

(a) The, date, hour andminute of beginningpost-mortem exami-nation.

(b) The, date, hour andminute of endingpost-mortem exami-nation.

5. Substance of accompa-nying Report from policeOfficer or Magistrate,together with the date ofdeath if known. Supposedcause of death or reason.for examination

,District Sivani

P.S. Ajani, Nagpur

Casualty,Govt. Medical College, Nagpur

PC Bhajandas , B. No. 5529, p.S. Ajani, Nagpur

12:45PM ltr-- 07t11t2017

_l

As per Police inquest and requisition.Date and time of death is O6t 1 I pA17 before 1 9: 1 S HrsH/O - Accident

+#t{€qrqsriFft;frqgv flgt

C.M.67e

DispensaryHospital

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F

6. lf not examined atDispensary or Hospital -

(a) Name of place whereexamined.

(b) Distance from Dis-pensary or Hospital-

(c) Reason why the bodywas not sent to theDispensary or Hospital.

ll. External Examination-

7. Sex, apparent age, raceor caste.

Description of clothesand of ornaments on thebody.

8. Condition of the clothes_Whether wet with water.stained with blood or soiledwith vomit or foecat mafter,

9. Special marks on the skinsuch as scars, tattooingetc., any rnalformationspeculiaritiesr or othermarks of identification.State of the teeth.

In newly born infants, thelength and (if possible), theweight of the body to berecorded together with thestate of the hair, nails andumbilical cord, its length,whether placenta isattached or not, if present,its size and condition.

Body brought dead to casualty,Govt. Medical College,Nagpur.

MaleAged about 25 years

gray barmuda'brown underwear'green t shirt,white baniyan,red thread weast

?:i1ff,?Jrentined by pc on duty

Not Appticable

Dry

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fi:fmff;"hed, thin

PM No. :NTS/2341/17 Dated : 07 t1't tZO17

Moderately BuiltCold

Present and generalized

No signs of decomposition present. Post mortem lividity present over back andbuttocks except at pressure point.

jiated, warm or cold'

11. Rigor Mortis - Well marked,slight or absent; whetherpresent in the whole bodY orpart onlY.

12. Extent and signs of decom-position, presence post-mortem lividity of buttocks,loins, back and thighs or anyother part. Whether bullaepresent and the nature oftheir contained fluid.Gondition of the cuticle.

13. Features - Whether naturalor swollen, state of eyes,position of tongue: natureof fluid (if any) oozing frommouth, nostrils or eaffi.

14. Condition of skin - Marksof btood etc. In suspecteddrowning the presence orabsence of cutis anserinato be noted.

Blood oozing out from the nostrils mouth and ears.

Dry and pale.

Feature

Eyes

CorneaMouth

Tongue

Crushed

ClosedHazy

Openedlnside the mouth

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4

No injury to external genitalsNo purging

15. lnjuries to external genitals.Indication of purging

16. Posi{ion of limbs -

Especially of arms andof fingers in suspectedclrowning the .presence orabsence of sand or earthwithin the nails or on theskin of hands and feet.

accurately stated-theirprobable age and causesto be noted.

lf bruises be present what isthe condition of thesubcutaneous tissues ?

lN.B.- (When injuries arenumerous and cannot bementioned within the spaceavailable they shculd bementioned on a separatepaper which should besignedi.

18. Other injuries discovered byexternal examination orpalpation as fractures etc.

(a) Can you say definitelythat the injuries shownagainst serial Nos. 17and 18 are ante morteminjuries?

Both limbs semi flexed

Refer tc column no. 17

crush injury of size 12 cm X g cm X craniar cavity deep present over reftte_mporo parito. occipiyal .region , bone , musclei , u,iri"f . , .ottorgans crushed,margins irregular.contused abrasion of size oi+ cm present over right sth 6th 7th ribs ataxillary line , transversely oblique, reddish.contused abrasion of size 4Xd cm present over posterior aspect of reft shourder, transversely oblique, reddish.

t'n;Y:.1

@

gr1To

17. Surtace wounds andinjuries - Their nature, posi-tiorl,dimensions(measured)and directions to be

z

,:.ct$$"'a .<A.^\u'

Yes, Antemortem

,t,t',#

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(iii)

ries under the scalp,

their nature'

Sku//- .Vault and base-

describe the fractures'their sites, dimen'sions, directions, etc.

Brain - The appearanceof its coverings, size,weight and generalcondition of the organitself and anyabnormalitY found in itsexamination to becarefully noted ( weightM. 3 grams F. 2.75grams).

PM No. :NTS/2341I'17 Daled'. O711112Q17

crushed injury present over left fronto temporo parito occipital regionunderline vessel muscles soft tissue crushed,brain matter not present atplaces left madible maxilla crushed flatning of face and skull.

Haematoma present over right 4th 5th 6th intercostal space about 40 cc blood andblood clots present, reddish in colour corresponding with injury no.2 mentioned incolumn no. 17.

200 cc of blood and blood clots present in both side of pleural cavity.

Mucosa-Pale Thyroid Cartilage-lntact. Hyoid Bone-lntact.

laceration present over lower lobe right lung of size about 2 cm,left lung intactpale.

Intact

Intact. Blood and blood clots present

lntact. Blood and blood clots present.

'oto

20. Thorax-

Walls, ribs, cartilages

(d) Right Lung

(e) LeftLung

(f) Pericardium

(g) Heart with weight

(h) Large vessels

I[i,

pleura --' j:-l-

- ---,,--\

Larynx, Trachea ""0\Bronchi.

(i) Additionalremarks. Nil

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t'

21. Abdomen-

Walls

Peritoireum

Gavity

Buccal Cavity, teeth,tongue and Pharynx.

Oesophagus

Stomach and its contents

Small intestine and itscontents.

Large intestine and itscontents.

Liver (with weight) and gallbladder.

Pancreas and Suprarenals

Spleen witft weight

Kidneys with weight

Bladder

Organs of generations

lntact.

Intaci.

No free fluid.

Mucosa - Pale.Intact.

Intact,Mucosa - Pale.

200 cc brownish color fluid, No peculiar odour., mucosa-pale .

Gases and faeces present

Congested

Congested

Pale

Pale

Empty

Intact.

Nil

Routine viscera not preserved

Additional remarks withwhere possible, medicalofficer's deduction from thestate of the contents of thestomach as to time of deathand last meal.

State which viscera (if any)have been retained forchemical examination andalso quote the numbers onthe bottles containing thesame.

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and Sqinal Cord-\-;

I

Contusion present over C3,C4 segment of spinal cord:

Whether the ante-mortem injuriesfound on the dead body weresufficient in the ordinary courseof nature to cause death.

(b) lf yes, which of the injuries wereindividually sufficient in theordinary course of nature to causedeath.

fct W1191 of the injuries coltectivetysufficient in the ordinary Cou.senature to cause death.

Opinion as to the causeprobable cause of death.

Yes

tc

+*4:'tiiJ

Internal injury mentioned under column no. 1g,20.22

Injury to vital organs

t

:': :r ^i

07t'|1t2017Dated

N.T.Sharnagat

(Signature)

,,il;to'n"' cord need not be examined unless there are any indications of disease, strychnine poisoning or

Note - The report must be-wriften and signed immediatery after the examination.. Medicar officers wiil at oncedespatch a duplicate "opy

to G-ciiii surg"on oitneir oirtii"ill, record in his office.

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(l

t o,*\

,t. <to-q

ar ^ NTS/2341117IYU.

07tl1t2417

Routine viscera not preserved.

Gopy forwarded with qompliments to the Civil Surgeon , for information.

Seen and examined by the Civil Surgeon, on

Remarks of the Civil Surgeon,

NIL.Submitted to concerned clerk, LMJ office

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II

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Civil Surgeon or M.M.S. Offict

M.M.S. Officer

Civil Surgeon