Page 12 - RIVER AUTOPSY WITH NOTATIONS

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15
.>EATH WAS CAUSED BY: IMMEDIATE CAUSE
0 EXAMINATION (D).
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AUTOPSY CLASS; D A.® B. D C.
Date I H-'1 3 Time 1z1 PENDING
Io 00 Dr. ~ FINAL ON.
0 TOX D NEURO
D HISTO D MED HIST. D OTHER
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- NATURAL g ACCIDENT O SUICIDE O HOMICIDE O UNDETERMINED If other than natural causes
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E TO. OR AS A CONSEOll!:.NCE OF
Other conditions contributing but not related to the immediate cause of death:
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ID I
Investigations
HOW DID INJURY OCCUR?
','AS OPERATION PERFORMED FOR ANY CONDITION STATED ABOVE?
:J Yes Q No _
D HISTOPATH ClJT: D AUTOPSY D LAB D MICROBIOLOGY;
D NEUROPATHOLOGY
TOXICOLOGICAL SPECIMENS COLLECTED
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[3 BLOOD; b?j HEART O (OTHER)
D BRAIN O SPLEEN O KIDNEY
O VITREOUS
T':"PE SURGERY
- PERTINENT COMMENTS:
ORGAN PROCUREMENT
- .,
DATE.
0 EVIDENCE RECOVERED AT AUTOPSY Item Description:
0 WITNESSES TO AUTOPSY:
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DATE ISSUED, ISSUED BY_ _ _ _ _ _ _ _
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0 SUPPLEMENTAL REQUEST (17A)
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·
TOXICOLOGICAL ANALYSES ORDERED SCREEN: ~ C D H D T
D ALCOHOL ONLy
0 CARBON MONOXIDE
0 OTHER (SPECIFY DRUG ANO TISSUE)
WHITE. FILE COPY
D X-RAY
D FLUORO