Page 719 - The Central Motor Vehicles Rules, 1989

ANNEXURE-XIII THE CENTRAL MOTOR VEHICLE RULES, 1989 691

Transferred to another hospital
Operation theatre
Intensive care unit
Died in Emergency Disposition
Brought Dead

52. History as stated by the Injured
53. Details of Injuries
54. Discharge Summary
i. Name of the doctor
ii. Doctor Regn No.

iii. Condition at admission
iv. Results of clinical investigation if any
v. Injuries diagnosed other than those
noted in the Wound Certificate, if any
vi. Details of treatment given, including
those of surgical and other
procedures if any
vii. Condition at discharge
viii. Advice given at the time of discharge
regarding further treatment if
necessary
ix. Remarks if any
55. Drunkenness Certificate

i. Whether under arrest or not Yes No
ii. Consent
iii. Date & time of examination
iv. History
v. Smell of alcohol in breath Present Absent
vi. Speech Normal
Thick and slurred
Incoherent
vii. Clothing Decently Dressed
Disordered
Soiled
Torn
viii. General Disposition Calm
Talkative
Abusive
Aggressive