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27/08/2024 14:21 52 Manual of Practical Forensic Medicine and Toxicology
(1D The findings of the examination may go against me.
(1 All this has been explained to me in
* Strike out in case examination is done under the provisions of Sec. 53 CrPC
Signaure and name of the witness
language which I can understand,
Signature/Thumb impression
Name
i and name of the person examined g
eee the person is unable to give ey,
due to insanity or is < 12 years)
Female nurse/attendant in presence of whom.
‘examination is conducted (if applicable)
General Physical Examination
Height __ cm Weight kg
Built: Poor/average/well
Secondary Sexual Characters
Signature
Name
Pulse. /min BP.
Male
aa ean Pie amet
Beard/Moustaches: Absent/downy/sparse/black/
bushy
Breast development: Not developed/developing
developed (Tanner stage
Pubic hair: Absentdowny/sparse/black/bushy
(Tanner stage 4)
Se
Pubic hair: Absent/downy/sparse/bla
(Tanner stage
Axillary hair: Absent/downy/sparse/black/bushy
Voice: Masculine/Feminine (Deep/soft)
Adams apple: Prominentinot prominent
Last menstrual period:
Genitals: ScrotalAesticular/penile devel me tals:
ee pe lopment Genitals:
eee)
Other Features
Acne
2 Eyes (Arcus senilis, cataract)
Wrinkles on face/skin
[a
Other features, if any: Requisition for cntaploseal Saniietion for or Estimation of Age
Department of Forensic Medicine and Toxicology
ee lee
Date
Ref. No.
To
The Professor/Medical Officer /C
Department of Radiology
Subject: Estimation of age of.
Dear Sir/Madam,
Ref, Requisition from
Trequest that radiographs of the subject may be taken as indicated below.
dated
The subject bears the following identification marks:
i
ae
2k
ea ei
request you that the X-ray plates may be sent to me at the earliest,
i
z
