1
INJURY REPORT
Memo no. 888 ................. Date 28/02/2020 ................ Officer in Charge.
Muksudpur .. Thana/Upazila .. Muksudpur .. Dist... Gopalgonj.
Perticulars of the Victim:
1. Name . Dalim sheikh 2. Age About 35 y
2. Fathers/Husband’s Name. Nuru sheikh
4. Address : Vill Kadampur. Post. Muksudpur,
Upazila- Muksudpur, Dist. Gopalgonj.
5. Date of Exam. 19-02-2020 6. Time Exam. 10.50 AM
7. Place of Exam. Emergency Room Muksudpur Upazila health
complex.
8. Date of Admission. 19-02-2020. 9. Date of Discharge. 23-02-2020
10. Indoor Reg. No. 693/9 Bed No. M/2 . Emergency Reg No. 213/06
Injury/Injuries
H/U Physical Annaull 1 & ½ hr Back
1. An Incisid wound over Right side of forehead measuring about 4
cm in length, 0.5 cm in deapth and 0.1 cm in width.
Age of injury:- 1 ½ hr
type of weapon used: Sharp cutting weapon.
Nature of injury- Simple.
2. Another Incisid wound length 2 cm Breadth 1 cm deapth 0.5 cm
of the Right lateral side of the forehead
Age of injury:- 1 ½ hr
2
type of weapon used: Sharp cutting weapon.
Nature of injury- Simple
3. Pain in the Rt hand over 4th
/5th
phalanges An T-ray of Rt hand in
advised, but t-ray report not shown by patient.
Age of injury:- 1 ½ hr
type of weapon used: Blunt weapon.
Nature of injury- Simple.
Signatured
05/03/2020
Member
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Signatured
05/03/2020
Member
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Attending Medical Officer
Signatured
05/03/2020
Member
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Muk GR 40-20 (Report).docx

  • 1.
    1 INJURY REPORT Memo no.888 ................. Date 28/02/2020 ................ Officer in Charge. Muksudpur .. Thana/Upazila .. Muksudpur .. Dist... Gopalgonj. Perticulars of the Victim: 1. Name . Dalim sheikh 2. Age About 35 y 2. Fathers/Husband’s Name. Nuru sheikh 4. Address : Vill Kadampur. Post. Muksudpur, Upazila- Muksudpur, Dist. Gopalgonj. 5. Date of Exam. 19-02-2020 6. Time Exam. 10.50 AM 7. Place of Exam. Emergency Room Muksudpur Upazila health complex. 8. Date of Admission. 19-02-2020. 9. Date of Discharge. 23-02-2020 10. Indoor Reg. No. 693/9 Bed No. M/2 . Emergency Reg No. 213/06 Injury/Injuries H/U Physical Annaull 1 & ½ hr Back 1. An Incisid wound over Right side of forehead measuring about 4 cm in length, 0.5 cm in deapth and 0.1 cm in width. Age of injury:- 1 ½ hr type of weapon used: Sharp cutting weapon. Nature of injury- Simple. 2. Another Incisid wound length 2 cm Breadth 1 cm deapth 0.5 cm of the Right lateral side of the forehead Age of injury:- 1 ½ hr
  • 2.
    2 type of weaponused: Sharp cutting weapon. Nature of injury- Simple 3. Pain in the Rt hand over 4th /5th phalanges An T-ray of Rt hand in advised, but t-ray report not shown by patient. Age of injury:- 1 ½ hr type of weapon used: Blunt weapon. Nature of injury- Simple. Signatured 05/03/2020 Member Wvt ZvgwR` BmwZqvK Lvb ‡KvW bs-138157 ‡gwW‡Kj Awdmvi KvwjbM`i Dc-¯^v¯’¨ ‡K›`ª gyKmy`cyi, †MvcvjMÄ| Signatured 05/03/2020 Member Wvt fx®§‡`e gÛj ‡KvW bs-136396 ‡gwW‡Kj Awdmvi Lvbcyiv Dc-¯^v¯’¨ ‡K›`ª gyKmy`cyi, †MvcvjMÄ| Attending Medical Officer Signatured 05/03/2020 Member Wvt gvmy`v Av³vi ‡KvW bs-138557 mnKvix mvR©b bbxÿxi BDwbqb Dc-¯^vÿ¨ †K›`ª gyKmy`cyi, †MvcvjMÄ|