KEPOLISIAN NEGARA REPUBLIK INDONESIA

DAERAH SUMATERA UTARA

BIDANG LABORATORIUM FORENSIK

FORMULIR PELAKSANAAN
OLAH TEMPAT KEJADIAN PERKARA (TKP)

1. Tempat Kejadian Perkara ( TKP) : ....................................................................................

Alamat TKP : ..............................................................................................
Permintaan dari : ..............................................................................................
Waktu Olah TKP : Tanggal ........./........../.........., Jam .................... WIB
2. Ketua Tim Labfor/Manager TKP :
a. Nama : .........................................................................................................
.
b. Pangkat : .........................................................................................................
.
c. Nrp : .........................................................................................................
.
d. Jabatan : .........................................................................................................
.
3. Penyidik Pendamping :
a. Nama : .........................................................................................................
b. Pangkat : .........................................................................................................
.
c. Nrp : .........................................................................................................
.
d. Jabatan : . .......................................................................................................
.
4. Barang Bukti yang di temukan di TKP (terlampir).
5. Sketsa TKP (terlampir).

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PENYIDIK KATIM LABFOR

.......................... ................................