DEATH INVESTIGATION REPORT

Case #       Case Officer       Date       Time      

VICTIM INFORMATION
Deceased       DOB       Age       SSN      
Address      
Telephone Work       Home      
Employed       Telephone      
Marital Status S M W D Partner/Roommate      
COMPLAINANT
Complainant       DOB      
Address       Telephone      
Relationship to Deceased      
Victim identified by       Relationship      
Address       Telephone      
Deceased found by       Relationship      
Address       Telephone      
Date Found       Time Found      
Location      
Deceased last seen by       Date       Time      
PHYSICAL DESCRIPTION OF VICTIM
Sex M F Race       Height       Weight       Glasses Y N
Eye color       Hair color       Length       Build      
Scars, Tattoos      
CONDITION OF BODY
Decomposed Preserved Cool Warm Clean Dirty Bloody Moved from Scene
Rigor Complete Partial Fingers Arms Legs Jaw
Lividity Fixed Extreme Minor Consistent with body position
Blood (If present – give location/amount/wet/dry)
Absent Present      

HISTORY OF DOMESTIC VIOLENCE

Was this death related to domestic violence? Yes No - If yes, complete the following:
Restraining Order in Effect? Type of Order:
Yes No Divorce Temporary Final
Witness present during domestic violence? Children present during domestic violence?
Yes No Yes No

PERSONNEL
First officer on scene       Officer in charge      
Case Officer – Primary       Secondary      
Entry Control/Log Officer      
Initial Responding Officers      
Forensic Lab Contacted       Arrived       Departed      

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Rescue Personnel
Rescue Squad       Crew Chief      
Time Called       Time Arrived      
Statements Taken Yes No Run Sheet Received Yes No
Deceased declared dead by       Time      
Deceased declared dead at Scene Hospital Other Town      
Personal Physician Contacted       Time      
Date/Reason for Last Exam      
Medical History      
Medical Examiner       Notified       Arrived      
State’s Attorney       Notified       Arrived      
Autopsy Ordered By      
Funeral Home       Arrived      
Deceased removed to      
Red tag attached to deceased       Time deceased removed      
Next of Kin       Relationship      
Address       Telephone      
Notification made by       at      
DESCRIPTION OF SCENE
Location/Room
     
Body Found
Position of Body      
Condition of
Entrances/      
Windows
PREMISES Orderly Cluttered Messy Staged Ransacked Dirty Odors
Evidence of Fighting Robbery Forced Entry Clean-up Injury
Description      
FORENSIC EVIDENCE
Weapons      
Ligatures      
Blunt Objects      
Firearms
     
Ammunition
Vehicles      
Blood Spatter      
Notes/Letters      
Latent Prints      
Evidence of Alcohol      
Evidence of Drug Use Prescriptions Non-Prescription Illegal
(Attach List) Other      

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 CLOTHING DESCRIPTION
Fully Clothed Partially Clothed Unclothed Ripped Dirty Neat Bloody
Shirts/Tops      
Pants/Skirt/Dress      
Underclothing      
Night Clothes      
Coat/Sweater       Shoes       Socks      
Hat       Gloves       Mittens      
Jewelry      
Pocket Contents      
TRAUMA – WOUNDS
None Stabbing Gunshot(s) Blunt Force Defense Asphyxia
Wounds Hesitation Bite Marks Ligature Abrasions Contusions
Lacerations
# of Wounds      
Locations      
Description      
SUSPECTED MANNER OF DEATH
Gunshot Wound(s) Stab Wound(s) Drowning
Cutting Wound(s) Crushing Injury Blunt Force Trauma
Torso Compression Electrocution Strangulation
Hypothermia Asphyxia Vehicular Accident
Explosive Trauma Hanging Malnutrition
Burns (Chemical) Dehydration Natural Causes
SIDS Burns (Fire) Burns (Scalding)
Poisoning (list)      
Other      
SUSPECTED CAUSE OF DEATH
Homicide Suicide Accidental Natural Unknown
ADDITIONAL INFORMATION
Photographs by       Video by      
Evidence turned over to      
Personal effects released to      
Scene secured by/Turned over to      
Time scene cleared      
Chain of Command Notified by       Time      
Press release completed by      
DPS Form 257 Completed      
Remarks -      

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 PRESCRIPTION DRUG INFORMATION
Name of Date of # or #
Medication Doctor Pharmacy Strength
Drug Rx Amount Left
                                               
                                               
                                               
                                               
                                               
                                               
                                               
                                               
                                               
                                               
                                               
REMARKS
     

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SCENE DIAGRAM

North

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 BODY DIAGRAM
Front Back

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