ME-8 Body ID (computer ready)

Date: 
05/05/2015
Document Text Version

Iowa Office of the State Medical Examiner
Department of Public Health
2250 South Ankeny Blvd.
Ankeny, IA 50023-9093
Phone: 515-725-1400
FAX: 515-725-1414

BODY IDENTIFICATION RECORD

Case Number:_____________________________

Date:____________________________________

Name of Decedent:__________________________________________

I,___________________________________________________,

hereby acknowledge that I have viewed

(Select One) photograph OR the body

of a deceased person believed to be:_________________________________________________

The photograph or body that I viewed is that of the above-named decedent.  I am related to the named decedent as:

Family (specify):________________________________________________________

Friend (specify:_________________________________________________________

Acquaintance (specify length of time known):_____________________________

Signed___________________________________________________________________

Date ____________________________________

Address:_________________________________________________________________

Telephone Number (include area code):____________________________________

Witness _________________________________________________________________

SCIENTIFIC AND SECONDARY IDENTIFICATION

(Indicate method[s] used and name of analyst)

Fingerprint Comparison:_________________

Fingerprint Analyst:_____________________________________________________

Dental Comparison: _____________________

Dental Analyst:__________________________________________________________

Hospital ID: ___________________________

Name of County ME:_______________________________________________________

Personal Effects (specify):______________________________________________

Law Enforcement Agency: ___________________

Name of Officer:_________________________________________________________

Circumstances (specify___________________________________________________

_________________________________________________________________________

Form ME-8 (11/05)

Printed from the Iowa Office of the State Medical Examiner website on October 29, 2020 at 8:25pm.