Page 178 - การสืบสวนสอบสวน

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สถานที่บันทึก...............................................

วันที่...................เดือน...................................พ.ศ.๒๕............
วันนี้เวลาประมาณ.....................น. ราษฎรผูจับ ชื่อ.......................................................
อายุ....................ป อาชีพ.............................................ที่อยู............เลขที่.................หมู.................

ถนน....................................................................ตําบล/แขวง..........................................................
อําเภอ/เขต..........................................................จังหวัด.................................................................

ไดจับ.................................................................................................................อายุ...................ป
ที่อยูเลขที่....................หมู.......................ตําบล................................................................................

อําเภอ.................................................................จังหวัด.................................................................
หมายเลขบัตรประจําตัวประชาชน....................................................................................

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พรอมดวยของกลาง......................................................................................................

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พฤติการณแหงการจับ...................................................................................................
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เจาพนักงานผูรับมอบตัวผูถูกจับ คือ..............................................................................

ตําแหนง..........................................................................................................................................
ไดแจงขอกลาวหาแกผูถูกจับวา......................................................................................
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และไดแจงรายละเอียดแหงการจับใหผูถูกจับทราบวา......................................................
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