•Dental examination
–3
rd
molar erupted in one qudrant but not formed
in other quadrants
•Radiological examination
–Pelvis shows-
•Iliac crest- appeared and fused
•Ischial tuberosity- appeared but not fused
Write the detailed proforma for age estimation
and issue the age certificate.
Proforma for Age estimation
•Requisition received from Inspector of SRMC,
Porur police station vide letter no 12345
dated 8/7/14 by PC 101.
•Place: SRMC, Porur
•Date: 8/7/14
Preliminary examination
•Requisition
•Name
•Sex
•Parent’s / Guardian’s name
•Address
•Occupation
•Married or single
•Age as alleged by
–Individual to be examined- 15 years
–Person or police accompanying by- 18years
•Person accompanying or brought by- PC no 101
•Time and place of examination 23/10/14, 2.00pm
•Consent of the individual for examination- : I hereby willingly consent to
let Dr.---- examine me and prepare a medico-legal report.
•Signature
•In case of minor, consent of guardian and his/her signature or left thumb
print
•Name of the female attendant/ nurse present at the time of examination
•Marks of identification
1.A circular black non-hairy mole, 2mm diameter present over right cheek.
2.A 2 cm linear scar horizontally placed present over right side neck,
situated 8cm below the angle of mandible.
Physical examination
•Height- 150cm Weight – 52kg
•Chest girth at the level of nipple
•Inspiration- 70cm Expiration- 65cm
•Abdominal girth at the level of navel- 85cm
•General built and appearance- averagely built
and nourished
•Voice- low and gentle with voice cracking
•Mammary development of breast- Nil
•Development of genitalia- scrotum and penis
developed.
•Onset of puberty
–Date of menarche
–Regularity of menses
•Date of sending case for radiological
examination
•Date of receiving report form radiologist
Radiological findings
–Pelvis AP view
•Iliac crest- appeared and
fused
•Ischial tuberosity-
appeared
•Ischial tuberosity-not
fused
•Inference
•> 18years
•> 16years
•<20 years
Age estimation certificate
•Opinion
–From physical, dental and radiological examination of –
bearing the identification marks
1.
2.
I am of the opinion that the individual is aged above 18 years
and below 20 years of age.
Place: SRMC, Porur Signature
Date: Name of Doctor
Regn No
Designation