National Guidelines on Management of Sexual Violence in Kenya
National Guidelines on Management of Sexual Violence in Kenya
National Guidelines on Management of Sexual Violence in Kenya
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Annex 3: P3 Form<br />
Annex 3<br />
P3 Form<br />
This P3 Form is free <strong>of</strong> charge<br />
THE KENYA POLICE P3<br />
MEDICAL EXAMINATION REPORT<br />
PART 1-(To be completed by the Police Officer Request<strong>in</strong>g Exam<strong>in</strong>ati<strong>on</strong>)<br />
From_____________________________________Ref____________________________________<br />
_________________________________________Date___________________________________<br />
To the___________________________________________________________Hospital/Dispensary<br />
I have to request the favour <strong>of</strong> your exam<strong>in</strong>ati<strong>on</strong> <strong>of</strong>:-<br />
Name__________________________________Age__________(If known)<br />
Address________________________________________________________________________.<br />
Date and time <strong>of</strong> the alleged <strong>of</strong>fence__________________________________________________<br />
Sent to you/Hospital <strong>on</strong> the__________________20__________<br />
Under escort <strong>of</strong>___________________________________________________________________<br />
and <strong>of</strong> your furnish<strong>in</strong>g me with a report <strong>of</strong> the nature and extent <strong>of</strong> bodily <strong>in</strong>jury susta<strong>in</strong>ed by him/her.<br />
Date and time report to police________________________________________________________<br />
Brief details <strong>of</strong> the alleged <strong>of</strong>fence<br />
_________________________________________________________________________________<br />
_________________________________________________________________________________<br />
_________________________________________________________________________________<br />
_________________________________________________________________________________<br />
Name <strong>of</strong> Officer Command<strong>in</strong>g Stati<strong>on</strong><br />
Signature <strong>of</strong> the Officer Command<strong>in</strong>g Stati<strong>on</strong><br />
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