Department of Forensic Medicine & Toxicology

Gajju Khan Medical College swabi.

Exhumation No_________ cccccccccc 00 Date______/_______/20

EXHUMATION PROFOMA

NAME OF THE DECEASED __________________________________ S/D/W/O ___________________________________

R/O ___________________________________________________________________________________________________

POLICE STATION ____________________________________________TEHSIL __________________________________

DISTRICT ___________________________________________________DIED ON _________________________________

BUREID ON _________________________ STATED AGE _______________________ SEX _________________________

FIRST AUTOPSY DONE ON ____________________________________________ AT _____________________________

BY DOCTOR ___________________________________________________________________________________________

EXHUMATION /RE-POST MORTTEM DONE ON ________________________________

1.______________________________________________________________________________________________________

2.______________________________________________________________________________________________________

3.______________________________________________________________________________________________________

4.______________________________________________________________________________________________________

5.______________________________________________________________________________________________________

IN THE PRESENCE OF
a. DUTAY MAGISTRATE ______________________________________________________________________

b. POLICE OFFICER __________________________________________________________________________

c. COMPLAINANT ____________________________________________________________________________

d. NOTABLES OF THE AREA _________________________________________________________________

UNDER THE ORDER OF (1) _____________________________________________________________________________

REFERENCE LETTER NO _______________________________________________________________________________

REFERENCE LETTER NO _______________________________________________________________________________

NAME OF GRAVE YARD ________________________________________________________________________________

LOCATION OF GRAVEYARD ___________________________________________________________________________

LOCATION OF GRAVE _________________________________________________________________________________

GRAVE IDENTIFIED BY;

a) ________________________________________________________________________________________________

RELATIONSHIP WITH DECEASED ______________________________________________________________________

b) ________________________________________________________________________________________________

RELATIONSHIP WITH DECEASED ___________________________________ N.I.C NO. _________________________

TIME OF ARRIVAL AT GRAVEYARD ____________________________________________________________________

TIME OF DIGGING _____________________________________________________________________________________

TIME OF CONDUCTION OF AUTOPSY ___________________________________________________________________

TIME OF THE FINISHING ______________________________________________________________________________

BRIEF HISTORY OF CASE

PRE-AUTOPSY DISUSSION

POINTS OF CONTROVERSY

OBJECTIVES OF EXAMINATION

OBSERVATION
CONDITION OF GRAVE SOIL. SANDY / CLAY/ WATER LOGGED/MARSHY/ ROCK/MIXED

RELATIONSHIP WITH SURROUNDING LANDS ___________________________________________________

DEPTH OF THE GRAVE _______________________________________________________________________________

COFFIN/ WRAPPING __________________________________________________________________________________

CONDITION OF WRAPPER ____________________________________________________________________________

EVIDENCE OF LST POST-MORTEM EXAMINATION _____________________________________________________

GENERAL BODY GUILT _______________________________________________________________________________

EVIDENCE OF SEX ____________________________________________________________________________________

EVIDENCE OF AGE ____________________________________________________________________________________

CONDITION SKIN _____________________________________________________________________________________

EVIDENCE OF EXTERNIL VIOLENCE

1 SKIN:
2 SUBCUTANEOUS TISSUES:

CRANIUM

1. VAULT:
2. MEMBERES:
3. BRAIN MATTER:
4. SPINAL CORDS:
REMARKS
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NECK

1. SOFT TISSUE:
2. HYOID BONE:
3. TRACHEA:
4. CERVICAL VERTEBRAE:
OPINION
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A: SIGNATURES

1. SIGNATURES: ________________________________________________________________________

NAME: ______________________________________________________________________________
 2. SIGNATURES: ________________________________________________________________________

NAME: _______________________________________________________________________________

3. SIGNATURES: ________________________________________________________________________

NAME: _______________________________________________________________________________

4. SIGNATURES: ________________________________________________________________________

NAME: _______________________________________________________________________________

CHEST:
1. BONY CAGE:
2. OESOPHAGUS/TRACHEA:
3. LUNGS:
4. HEART:
5. BLOOD VESSELS:

ABDOMEN:
1. PERITIONIUM
2. STOMACH
3. PANCREAS
4. LIVER
5. SPLEEN
6. INTESTINES
7. KIDNEYS
8. BLADDER
9. ORGANS OF GENERA

LOCOMOTOR SYSTAM
1. BONES
2. JOINTS
3. MUSCLES
PRESERVATIONS
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DISPATCHED TO
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REMARKS
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 ATTENDANCE SHEET

POST-MORTEM EXAMINATION ON THE EXHUMED DEAD BODY OF DECEASED

R/O _________________________________________ P.S. ___________________________________________

TEHSIL _____________________________________ DISTRICT _______________________________________

AT GRAVEYARD _____________________________________ ON ____________________________________

UNDER ORDERS OF:

A) __________________________________________________________________________________

REFERENCE NO. _____________________________________________________________________________

B) __________________________________________________________________________________

A. MEMBERS OF SPECIAL MEDICAL BOARD

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________

5. ___________________________________________________________________________

6. ___________________________________________________________________________

7. ___________________________________________________________________________

8. __________________________________________________________________________

9. ___________________________________________________________________________

10. ___________________________________________________________________________

B. DUTY MAGISTRATE:
C. POLICE OFFICER:
D. COMPLAINANT:
E. NOTEABLE OF THEAREA