Post Mortem Certificate Book No.___________________________________ Sr. No. of. Autopsy____________________________ Name of the Institution / Hospital_________________ Reference No. of requisitioned___________________ Owner s Name / Address_______________________ Date & Time of death__________________________ Date & Time of receipt of the carcass_____________ Date & Time of Autopsy performed_______________ Autopsy performed by Dr._________________________ at Place_______________ Description of Carcass Species__________________ Breed______________ Age_____________________ Sex________________ Color Identification marks Natural________________________ Acquired_______________________ Tag No.________________________ History A. Body condition and External findings B. Internal findings. 1 Condition of Lymph nods & serous Membrass. 2 Buccal cavity. 3 Thoracic cavity 4 Abdominal cavity 5 Pelvic cavity 6 Cranial cavity 7 Any other abnormality witnessed Opinion:- Date of Issue of:- (Postmortem Report) Signature / Thumb impression of requistioner:- Signature (Name in block letters with office seal of issuing authority) Designation Regd.No._______ (Pb.Vety. Council.) Received Fee of Rs._________ Vide receipt No. __________Dt._______________
