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Sep 13, 2014
Kursk regional Bureau of Medico-legal examinations
Forensic medicine department of the Kursk State Medical University
Kursk town, Salovaja street 42-a
REPORT № ________of the medico-legal autopsy
Autopsy date: “______” ________________ 200____ year from _________ till ________ hrs
According to decree of ___________________________________________________________
____________________________________ from “______” ________________ 200____ year
at the morgue of Kursk regional Bureau of Medico-legal examinations
Forensic medical examiner:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
are performed the Medic-legal autopsy of:
Name:_______________________________________________________________________
_____________________________________________________________________________
Sex: male/female
Date of born_____________________ Age: _________ years old.
The students of group _____ medical faculty of the KSMU were attended during the autopsy
The known plot of case___________________________________________________________
_____________________________________________________________________________
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After autopsy we must answer on following questions:1. What is a cause of death?2. Are any injuries present?3. What is a time of death?
Autopsy record № _______________
DATA OF EXTERNAL EXAMINATION:
Dress and other wearing apparels: __________________________________________________
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Body’s length ___________ cm.;
Build, constitution_______________________________________________________________
Scalp hair (color, length) _________________________________________________________
Condition of the eyes: closed / opened; Corneas: hazy / clear
Iris _____________________________ (color);
Condition of the pupils: shape:__________________ size _____________________cm.
Conjunctivas: __________________________________________________________________ _____________________________________________________________________________
Nose ________________________________________________________________________ Mouth: closed / opened; Teeth: ___________________________________________________ Right Left
8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 upper jaw________________________________________
8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 lower jaw
Position of the tongue: ___________________________________________________________
Neck: ________________________________________________________________________
Thorax: _______________________________________________________________________
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Autopsy record № _______________
Female breasts: ________________________________________________________________
Abdomen: _____________________________________________________________________
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Genitalia: _____________________________________________________________________
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Extremities: __________________________________________________________________
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Post mortem changes:
Time of the reaction of the pupil to atropine (pilocarpine) ________________________ min/sec.
Reaction of the muscles to mechanical stimuli ________________________________________
Cooling of the body: on the surface of skin __________________________________________
Temperature in rectum: ___________________________° C.
State and distribution of the rigor mortis: ____________________________________________
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State and distribution of the livores mortis: situated at__________________________________
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colour:________________________________________________________________________
Changes after pressure:__________________________________________________________
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State and distribution of the putrefaction: ____________________________________________
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Autopsy record № _______________
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_____________________________________________________________________________Blood, mud or other stains on the surface of body: _____________________________________
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External injuries (site, type, shape, size and peculiar properties): __________________________
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Additional notes: _______________________________________________________________
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Autopsy record № _______________
DATA OF INTERNAL EXAMINATION:
Thoracic cavity_________________________________________________________________
_____________________________________________________________________________
Tongue: ______________________________________________________________________
_____________________________________________________________________________
Larynx: Mucosa membrane ______________________________________________________
Cartilages _____________________________________________________________
Hyoide bone ___________________________________________________________
Trachea _______________________________________________________________________
Major bronchi _________________________________________________________________
Oesophagus ___________________________________________________________________
_____________________________________________________________________________
Lungs: _______________________________________________________________________
Left: ___________________________________________________________________
_____________________________________________________________________________
_______________________________________________________Weight ______________g.
Right: __________________________________________________________________
_____________________________________________________________________________
_______________________________________________________Weight ______________g.
Heart _________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Size: ______× ________×________ cm; Weight ______________g.
Thickness of the wall of left ventricle ______cm; of right ventricle ______cm5
Autopsy record № _______________
Coronary arteries _______________________________________________________________
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Aorta: ________________________________________________________________________
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Ribs: _________________________________________________________________________
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Abdominal cavity _______________________________________________________________
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Stomach ______________________________________________________________________
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Small intestine _________________________________________________________________
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Large intestine _________________________________________________________________
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Liver _________________________________________________________________________
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Size: _______× ________×_______×_______ cm; Weight: ______________g.
Gall bladder ___________________________________________________________________
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Autopsy record № _______________
Spleen: _______________________________________________________________________
_____________________________________________________________________________
Size: ______× ________×________ cm; Weight ______________g.
Pancreas: _____________________________________________________________________
_____________________________________________________________________________
Size: ______× ________×________ cm; Weight ______________g.
Kidneys: ______________________________________________________________________
Left: ___________________________________________________________________
_____________________________________________________________________________
Size: ______× ________×________ cm; Weight ______________g.
Right: __________________________________________________________________
_____________________________________________________________________________
Size: ______× ________×________ cm; Weight ______________g.
Urinary bladder: ________________________________________________________________
_____________________________________________________________________________
The head:
Scalp: __________________________________________________________________
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Skull: __________________________________________________________________
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Autopsy record № _______________
Brain: __________________________________________________________________
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Brain vessels: ___________________________________________________________
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Additional notes: _______________________________________________________________
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Forensic medical examiner: _____________________________________8
Autopsy record № _______________
DATA OF LABORATORY EXAMINATIONS:
1. Chemical examination: ________________________________________________________
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2. Microscopic examination _______________________________________________________
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Biological examination __________________________________________________________
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Autopsy record № _______________
CONCLUSION:
Cause of death: _________________________________________________________________
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Injuries: ______________________________________________________________________
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Time of death: _________________________________________________________________
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Forensic medical examiner: _____________________________________
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Autopsy record № _______________
Appendix № 1
SCHEMATIC PICTURE OF INJURIES, WHICH ARE FOUNDED ON THE BODY
- abrasions- bruises- wounds
Forensic medical examiner: _____________________________________
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