Criminal

PROFORMA FOR EXAMINATION OF RAPE ACCUSED (MALE)

PROFORMA FOR EXAMINATION OF RAPE ACCUSED (MALE)

Requisition form_____________________of Police Station______________

vide his letter No.______ ___ __________Dated_______________________

Name (in full) _______________________________________

Age by appearance______________Sex____________M.L.C. No._________

Occupation_________________Address________________________________

Date of Examination______________ Time of Examination________________

Alleged time of offence_______AM/PM Married/Unmarried_________

Brought by____________________________________

Consent for examination_______________________________________________

(Note : Explain to the individual that the physical examination findings will be used as evidence whether or not in his interest and he is free to refuse being examined if he chooses)

Thumb Impression/Signature

Identification Marks (1) _____________________________

(2) _____________________________

History

Specifically enquire about

a. Whether bath was taken? If yes, When ?
b. Whether motion was passed? If yes, When?
c. Clothing changed? If no, describe any damage/stains.

Physical Examination

Height___________ cms

Weight_______________ Kgs.

General Build and Appearance.

Marks of general violence on the body as bite marks, scratches etc.

General Behaviour (Mental condition & Signs of Drunkenness, if any):

Pubic region and thighs. (look for matting of hair, stains)

injuries on Genitals/Scars.

Has Vasectomy been performed? If yes, look for the Scar.

Is there any evidence of S T D?

Genitals :

Penis
Prepace
Smegma

Public Hair Length ____________ Matted or Not
Normal/Abnormal, describe the Abnormality:

Circumcised Yes/No Any Injury:

Present/Absent Any Evidence of Impotence

Microscopic examination of discharge if present:

Blood Group examination (if necessary)

OPINION:

Station :

Date :

Signature of Medical Officer
Name: Degree
Designation Reg No.
To,
SI ________________________of_________________________Police Station

Note :

a. Examination for Age Estimation to be carried out, if necessary.
b. If impotence is the plea, examination in detail for Impotence to be carried out.

Form of Report to be used when Forwarding Substances other than Viscera to

The Chemical Analyser No:

From :

To

The Chemical Analyser,

___________________ Dated:

Forwarding the articles mentioned below for examination for

____________________________ in connection with the case of

DESCRIPTION OF ARTICLES

Mode of packing and weight of parcel Copy of label and impression of seal

If standard boxes and bottles are used

a) Box No

b) Bottle No

Mode of dispatch Date and receipt in Chemical Analyser’s

Date : Office

Facts of Medico-legal importance in connection with case:

Station:

Date:

Civil Surgeon or Medical Officer in-charge

Categories: Criminal

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