ACTA DE LEVANTAMIENTO DE CADVER

I. DATOS GENERALES.
Fiscala a cargo de la diligencia: _________________________________________
Nombre y apellidos del Fiscal interviniente: ________________________________
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En _______________________ siendo las ____________ horas del da
________del mes _______________ del ao ___________, el Sr. Fiscal (o Adj.) de
la Fiscala de Turno de _____________________________ Dr. (a)
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Conjuntamente con el Mdico Legista Dr. (a)
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y los efectivos policiales intervinientes e identificados como (nombre y cargo):
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Nos constituimos en
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A fin de efectuar la presente diligencia.

II. INFORMACIN DEL AGRAVIADO / OCCISO

1. Nombre y apellidos del agraviado / occiso.
_______________________________________________________________
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2. Edad aproximada:
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3. Documento de Identidad ( tipo y nmero)
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III. DEL LUGAR DE LOS HECHOS

Descripcin del occiso:
Posicin del cadver
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Ubicacin del cadver
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Describa la ropa que tena puesta el occiso (estado, color, No. de bolsillos, tipo de
prenda):
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Describa el fsico del occiso con nfasis en caractersticas particulares o peculiares:

(Cicatrices, tatuajes, barba, bigote, huecos en lbulos de las orejas, en la nariz,
etc.). Incluir raza, estatura y peso aproximado:
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Describa signos de violencia en el occiso:( heridas, golpes, contusiones, fracturas,

arrastre, sangre: en la escena y en el cuerpo del occiso) segn lo sealado por el
perito:
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Otras:
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En el Registro personal se encontr las siguientes especies (Enumere y describa

los artculos encontrados en los bolsillos y/o sobre la persona y su posicin con
relacin al cadver):
1. _______________________________________________________________
2. _______________________________________________________________
3. _______________________________________________________________
4. _______________________________________________________________
5. _______________________________________________________________
6. _______________________________________________________________
7. _______________________________________________________________
8. _______________________________________________________________
9. _______________________________________________________________
10. _______________________________________________________________
11. _______________________________________________________________

IV. DIAGNOSTICO PRESUNTIVO DE MUERTE (Determinar causa bsica y causa

final)
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TIEMPO APROXIMADO DE MUERTE (Meses, Das, horas)

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V. JUSTIFICACIN DEL REQUERIMIENTO DE NECROPSIA \ IDENTIFICACIN.

(Art.196 NCPP)
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--- En cumplimiento del Artculo 195 del Nuevo Cdigo Procesal Penal se ordena el
Levantamiento del Cadver disponindose su traslado por
___________________________________________________________________
__ a la ____________________________________________________________
De _______________________ para la Necropsia, identificacin o ambas (Art.196
NCPP).
--- Debiendo remitirse el resultado de la (s) pericia (s) a la Fiscala a cargo del caso,
con lo que concluye la presente diligencia firmando los intervinientes:

Hora, Lugar y fecha: __________________________________________________

Firma: _____________________ ____

Cargo: ______________________ Cargo: ___________________________

Firma: ______________________ Firma: ___________________________

Cargo: ______________________ Cargo: ___________________________

Firma: ______________________
Cargo: _____________________ Firma: ___________________________
Firma:_______________________ Cargo: ___________________________