You are on page 1of 5
Lr 023 12:02:13 PM yop 1146808 una ee ai mergencY poe Rs 2802 cy 0408 fox EF ou petarees soni te jo of Doctor with State savn van ni (10 nna see wih ie NSENT FORM MedLESPR - Haryana cit Hospial Amaia City arvana rer) edi Legal Report share) -81106000132302467 ated 04/1172023 1140272023 Dated 04/11/2023 by Doetor!>MUR MLR Noone” Gacieribwctors who examined the patient Registration No ol = —Toesignation \Counciinact = fine ofa be Haale FH A TUTE st eae et vel GE EL Re tT at Aa TM | Se are wen won / we 1H He A a gators, fiat, cROWE Wt Bs (auf rrr shat eit eT afeerot farat var t aT cere ( ate Ofte ah 1 Facer | 9289) emer / area | WA | GURPREET SINGH Slo SUKHNWINDER SINGH MAIN REPORT MedLEaPR - Haryana Civil Hospital Ambala Gity aN Haryana (Form-ti) =f Medical Legal Report Dated 04/11/2023 2.44106000132302467 vr no( Generates by Sonar Dated 04/11/2023 ¢):-MLRIPJI1 1102/2023 MLR No{Given by Doctor JONSENT FORM IS TAKEN SEPARATELY BEFORE EXAMINATION WHICH IS ATTACHED WITH MLR REPORT. ¢ a = smined the patient: lo ~Tesignation Registration No of Doctor with State ee ee ICouncil/MCl | IMO 7 96367 Stale Medical Councit Delhi sh Jain mt Sh/SmuMiss Me, GURPREET SINGH lo SUKHWINDER SINGH ‘Age(Approx) 24 Years Gonder Male Marital Status: Unmarried Occupation FarmerZamindar Address Present Address TINO 475 VILLAGE KAWLA AMBALA MOB.8221082307 Police Station SEC 9,Ambala,Haryana Permanent Address H.NO 475 VILLAGE KAWLA AMBALA, MOB,8221082307 Police Station SEC 9,Ambala,Heryana Country Date of arrival (04/41/2023 Time of arrival(in hrs) 11:59 Date of Examination 04/11/2023 Time of Examination(in hrs) 11:59 Place of examination: Emergency Police Person Detail: Self Dr Plyush Jain (drplyush2012@gmail.com) Printed on: 04/11/2023 12:14:44 PM. 2 MAIN REPORT MedLEaPR - Haryana Civil Hospital Ambata City Haryana , earl (Form-tl) Y Sof - Medical Legal Re ; oe ware) :-m106000132302467 ene erson. Accom, OF): MLRIP/14102/2023, eos aE Panied Detail: Yos eer + [Address Relation with Reto Police Station District, State Signature KUMHAR, KOMAR Cousin JAmbala city Ambala,Haryana JAMBALA city ee Marks of identification Sr.No. [ Mdentitication Details 1 OLD HEALED SCAR MARI ik WAS PRE: eee NEAR THE MEDIAL GANTHES OF | LErTeve: NED ASPECT OVER THE LEFT NOSE [OPD Detair OPD No. 4 [2862 Gist of incident as stated by the injured/accompanying person Gist of Incident |A/H/O PHYSICAL ASSAULT BY NAVDEEP WITH METALLIC ROD AT JAGGI COLONY AMBALA CITY ON 04/11/2023 AT 11:30AM.HE ALSO HAD A GUN WITH HIM WHICH HE TRIED TO THREATEN AND. |SHOOT ME.BUT | DID NOT GOT SHOT AND JUST HEARD THE NOISE OF GUNSHOT. |General condition of the person, clothing etc. ‘ Condition [ORIENTED TO TIME PLACE AND PERSON. GCS 15/15 [Marked Injury Number 1 injuries [A LACERATED WOUND OF SIZE 5X 2CM WAS PRESENT OBLIQUELY |No OVER THE POSTERIOR ASPECT OF LEFT FOREARM AT THE UPPER IHALF.BLEEDING PRESENT.MARGIN WERE IRREGULAR WITH INTERVENING SOFT TISSUE PRESENT IN BETWEEN. PAIN AND TENDERNESS PRESENT. JADV.X-RAY LEFT FOREARM/AP/LAT/ORTHO OPINION Dr Piyush Jain (drpiyush2012@gmail.com) . Printed on; 04/11/2023 12:14:44 PM

You might also like