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 ieNSENT 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 SINGHMAIN 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.
2MAIN 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