Gujarat Ayurved University, Jamnagar All Affiliated Ayurved Colleges This is to Certify that Mr/Miss of Year student has completed.. Postmortem cases in the subject of.. Under our guidance. Jamnagar Date: Signature of Professor/H.O.D Sign of Examiner-1 Sign of Examiner-2 Page 1 of 7
Gujarat Ayurved University, Jamnagar All Affiliated Ayurved Colleges Name of the Student Examination Year Practical Index Roll No Sr. No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Type of Postmortem case Date of Postmortem examination Signature of the Student Signature of the Concerned Teacher Student Sign H.O.D Sign Page 2 of 7
Department of Agadtantra-Vyavahar Ayurved Evum Vidhivaideyak Post mortem Examination Memorandum of post mortem examination held at. Hospital on the dead body of... Village/city Taluka District by Dr... A. General Particulars a) By whom was the corpse sent? : b) Name of place from where sent. : c) Distance from place sent. : 1. By whom was the corpse brought? : 2. By whom identified? : 3. The date, hour and minute of receipt. a) The date, hour and minute of beginning : Post mortem examination. b) The date, hour and minute of ending : Post mortem examination. 4. Substance of accompanying report from : police officer or magistrate, together with the date of death, if known, supposed cause of death, or reason for examination. 5. If not examined at dispensary or hospital a) Name of place where examined : b) Distance from dispensary or hospital : c) Reason why the body was not sent to the dispensary or hospital : B. External Examination Page 3 of 7
6. Sex, apparent age, race or cast : Description of clothes and ornaments on the body. 7. Condition of the clothes : Whether wet with water, stained with Blood or soiled with vomit or faecal matter 8. Special marks on the skin such as scars, : tattooing etc. any malformation, peculiarities, or other marks of identification. State of the teeth. In newly born infants, the length and (if possible) the weight of the body to be recorded together with the state of the hair, nails & umbilical cord, its length, whether placenta is attached or not, if present size and condition. 9. Condition of body: whether well-nourished, thin or : emaciated, warm or cold 10. Rigor mortis: well marked, slight or absent : Whether present in the whole body or part only 11. Extent and signs of decomposition, presence : of post-mortem lividity on buttocks, joints, back and thighs or any other part. Whether bullae present and the nature of their contained fluid, condition of the cuticle. Page 4 of 7
12. Features: whether natural or swollen, state of eyes : position of tongue, nature of fluid (if any) oozing from mouth, nostrils or ears. 13. Condition of skin: marks of blood etc. In suspected : drowning the presence or absence of cutis anserine to be noted. 14. Injuries to external genitals, indication of purging : 15. Position of limbs: especially of arms and of fingers : In suspected drowning the presence or absence of sand or earth within the nails or on the skin of hands and feet. 16. Surface wounds and injuries: their nature, position : dimensions (measured) and directions to be accurately stated-their probable age and cause to be noted. If bruises are present, what is the condition of the S/C tissue. 17. Other injuries discovered by external examination : or palpation, as fractures etc a) Can you say definitely that the injuries shown : against serial nos 16 and 17 are ante-mortem injuries? Page 5 of 7
C. Internal Examination 18. Cranial cavity: a) Head- 1) Injuries under the scalp, their nature. : 2) Skull: describe fractures, their sites, dimensions : direction etc. 3) Brain: the appearance of its coverings, size, : weight and general condition of the organ itself and abnormality found in its examination to be carefully noted. 19. Neck : 20. Thorax : a) Walls, ribs, cartilages : b) Pleura : c) Larynx, trachea and bronchi : d) Right lung : e) Left lung : f) Pericardium : g) Heart with weight : h) Large vessels : i) Additional remarks : 21. Abdomen : a) Walls : b) Peritoneum : c) Cavity : d) Buccal cavity, teeth, tongue and pharynx : Page 6 of 7
e) Oesophagus : f) Stomach and its contents : g) Small intestine and its contents : h) Large intestine and its contents : i) Liver (with weight) and gall bladder : j) Pancreas and suprarenals : k) Spleen with weight : l) Kidneys with weight : m) Bladder : n) Organs of generation : 22. Spine and spinal cord : 23. Additional remarks with where possible : medical officer s deduction from the state of the contents of the stomach as to time of death and last meal. 24. State which viscera (if any) have been retained : for chemical examination and also quote the numbers on the bottles containing the same. 25. Opinion as to the cause, or probable cause of death : Date: Signature of the student Teacher s Signature Page 7 of 7