Medico-Legal Certificate Format
A Medico-Legal Certificate typically includes the following elements:
- Header: Includes the name of the issuing hospital or medical institution, address, and contact information.
- Title: Clearly states “Medico-Legal Certificate.”
- Patient Information: Name, age, sex, and address of the patient.
- Date and Time of Examination: When the examination was conducted.
- Findings: Detailed description of injuries or conditions observed, including location, size, and nature of wounds or injuries.
- Diagnosis: Medical opinion on the cause and nature of the injuries.
- Certifying Physician: Name, signature, and license number of the physician who conducted the examination.
- Date of Issuance: When the certificate was issued.
Medico-Legal Judicial Affidavit Format
JUDICIAL AFFIDAVIT
I, [Name of Medico-Legal Officer], of legal age, with office address at [Office Address], after having been duly sworn in accordance with law, do hereby depose and state:
- Personal Information
- Name: [Full Name]
- Age: [Age]
- Residence or Business Address: [Address]
- Occupation: Medico-Legal Officer
- Examination Details
- Name and Address of Lawyer Conducting Examination: [Lawyer’s Name and Address]
- Place of Examination: [Location]
- Oath and Awareness
- I am answering the questions asked of me fully conscious that I do so under oath and that I may face criminal liability for false testimony or perjury.
- Questions and Answers
- Q1: [Question 1] A1: [Answer 1]
- Q2: [Question 2] A2: [Answer 2]
- (Continue with all relevant questions and answers, ensuring they are consecutively numbered)
- Documentary Evidence
- Attached hereto are the following documents which I have identified and authenticated:
- Exhibit A: [Description of Document]
- Exhibit B: [Description of Document]
- I warrant that the copies attached are faithful reproductions of the originals.
- Attached hereto are the following documents which I have identified and authenticated:
- Signature and Jurat
- [Signature of Medico-Legal Officer]
- [Printed Name of Medico-Legal Officer]
SUBSCRIBED AND SWORN to before me this [Date] at [Location], affiant exhibiting to me his/her [ID Type and Number].
[Signature of Notary Public] [Printed Name of Notary Public] [Notarial Commission Number]