Sample request Format of Medico-Legal Examination
(Autopsy)
Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
_________________________________________
___________________________
MEMORANDUM
FOR
:
FROM
:
SUBJECT
:
DATE
:
Director, PNP Crime Laboratory
Request for Autopsy Examination
1.
Request conducts medico-legal (autopsy)
accompanying specimen to determine the cause of death.
a)
NATURE OF CASE :
b)
VICTIM
:
c)
SUSPECT
:
d)
TDPO
:
e)
SPECIMEN SUBMITTED :
examination
on
the
2.
Further request that this Office be furnished a copy of medico-legal
examination result for our reference.
3.
For consideration.
____________________________
(CHIEF OF OFFICE)