Death Certificates

‫‪:‬بيانات المتوفى‬ ‫االسم الكامل ‪-‬‬

‫النوع ‪-‬‬ ‫الديانة ‪-‬‬

‫تاريخ و محل ‪-‬‬ ‫القامة‬

‫الجنسية ‪-‬‬

‫محل القيد بالسجل ‪-‬‬ ‫المدنى‬

‫السن ‪-‬‬

‫جهة الوفاة ‪-‬‬

‫الحالة العائلية ‪-‬‬

‫مكان الوفاة ‪-‬‬

‫العنوان ‪-‬‬

‫تاريخ الوفاة ‪-‬‬

‫البطاقة ‪-‬‬

‫بيانات المبلغ‬ ‫‪:‬‬ ‫السم ‪-‬‬ ‫البطاقة ‪-‬‬ ‫علقته بالمتوفى ‪-‬‬ ‫عنوان محل القامة ‪-‬‬

‫‪:‬شهادة الوفاة الطبية‬ ‫(‪ )I‬أ‪ :‬السبب المباشر للوفاة ‪:‬‬ ‫ب‪ :‬أحوال مرضية أو إصابية إن وجدت نشأ عنها السبب المباشر‬ ‫‪:‬للوفاة‬ ‫‪:‬ج‪ :‬المرض أو الصابة الصلية‬ ‫(‪ )II‬أحوال مرضية إن وجدت ساعدت على حدوث الوفاة و ليس‬ ‫لها علقة بالمرض الصلى‪:‬‬ ‫إسم الطبيب‬ ‫التوقيع‬ ‫التاريخ‬

pulmonary embolism: sever chest pain hemoptysis tachycardia tachypnea hypotension and cyanosis.

An elderly pedestrian was hit from the back by a car, she sustained bruises of Rt. Leg .she confined to bed and died after 10 days. Autopsy showed a massive pulmonary embolism with thrombosis of the veins of Rt. Leg.

‫ انحذاف رئوي‬-‫)أ‬2( ‫ جلطة بأوردة الساق‬-‫ب‬ ‫ رقاد طويل بالفراش‬-‫ج‬ ‫) ل يوجد‬2(

During a quarrel a man has received a strong blow on the lower part of the abdomen, he was carried home, next day he died. on examination the urinary bladder was found ruptured , inflamed , there was general peritonitis. ‫ التهاب بريتوني حاد‬-‫)أ‬2( ‫ انفجار المثانة البولية‬-‫ب‬ ‫ ضربة أسفل البطن‬-‫ج‬ ‫) ل يوجد‬2(

When an old man who has been depressed, was not seen for a few days, his neighbors call for the police. On breaking his apartment door, he was found lying on bed and a revolver was clenched in his Rt. hand .On examination a gunshot wound was found on his Rt. Temple. ‫ طلق ناري انتحاري بالرأس‬-‫)أ‬2( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬

A middle-aged woman, who was suffering from bronchial asthma, was found dead at home dressed in underclothes. On examination there were discoid bruises about 1 Cm in diameter and semilunar abrasions on the front & sides of the neck, internal examination showed massive contusions of the neck soft tissue and a fracture of the hyoid bone.

‫ اسفكسيا الخنق باليد‬-‫)أ‬2( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ ‫) الربو الشعبي‬2(

A pregnant female tried to end her pregnancy. She introduced a douching nozzle and gushed a large amount of soap into the uterus. She died suddenly after she felt a sever chest pain, hemoptysis, tachycardia, tachypnea, hypotension and cyanosis. ‫ انحذاف رئوي‬-‫)أ‬2( ‫ محاولة اجهاض‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ ‫) ل يوجد‬2(

A haemophilic child was playing with fellows when he was struck on the Lt. temple by a stick ,he staggered and fell momentarily concussed , but got to his feet. Next morning, he was found unconscious, feverish, there was rigidity on the muscles of the back of the neck, signs of lateralization .on his way to hospital he died. )2(

‫هيموفيليا‬

‫ انضغاط بالمخ‬-‫)أ‬2( ‫ نزيف بالمخ‬-‫ب‬ ‫ اصابة بالرأس‬-‫ج‬

During playing of one baby by a belt he tied it around his neck .He became cyanosed, unconscious, his mother tried to save him by removing the belt but she failed, and the baby died. ‫ اسفكسيا الخنق بالحبل‬-‫)أ‬2( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ )2( ‫ل يوجد‬

During a war an alarm was sounded, people hurried to the ground floor. a woman fell on the stairway and people ran over her crushing her chest & abdomen. On examination, face & neck were deeply cyanosed with numerous petechiae over head, neck and shoulders. ‫ اسفكسيا اصابية‬-‫)أ‬2( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ ‫) ل يوجد‬2(

During playing of one baby by a coin, he aspirated it on his trachea, he become cyanosed, unconscious. He received treatment in emergency room but he died. during autopsy, we found deep blue hypostasis , the right side of the heart , great vessels were congested, also, the lung was congested. ‫ اسفكسيا الشرق‬-‫)أ‬2( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ ‫) ل يوجد‬2(

A 20 year old man collapsed during football practice on a hot humid day )atmospheric temp. 45( on admission to hospital, he was comatose, B/P=70/20, body temperature was 42⁰c with mild sweating, he developed seizures, died. ‫ ضربة شمس‬-‫)أ‬3( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬

An alcoholic fell on a bare electric wire and died. No external signs were found. ‫ صعق كهربي‬-‫)أ‬3( ‫ ل يوجد‬-‫ب‬ ‫ ل يوجد‬-‫ج‬ ‫) تعاطي الكحول‬2(

A 30 year farmer with bilharzial splenomegaly & chronic anaemia was severely shocked after a severe attack of haematemesis & melena & died on arrival to hospital. ‫ قيئ دموي‬-‫)أ‬3( ‫ انفجار دوالي المرئ‬-‫• ب‬ ‫ تليف كبدي بلهارسي‬-‫• ج‬ ‫) انيميا‬2( •

A diabetic man who had been on a therapy for angina suddenly suffered from chest pain radiating to the left arm, dyspnea & sweating. He died on his way to the hospital ‫ احتشاء بعضلة القلب‬-‫)أ‬3( ‫ قصور في الشرايين التاجية‬-‫• ب‬ ‫ تصلب الشرايين‬-‫• ج‬ ‫) مرض البول السكري‬2( •

An alcohol addict man was found dead in a smoke filled room. He had sustained moderate burns on his right hand. On examination, skin was red in color, alcohol level was 100 mg %, and carboxyhemoglobin level was 80%. ‫ تسمم بغاز أول أكسيد الكربون‬-‫)أ‬3( ‫ ل يوجد‬-‫• ب‬ ‫ ل يوجد‬-‫• ج‬ ‫) تعاطي الكحول‬2( •

An eight years old boy was knocked down the road by a speeding motor vehicle and died on the spot. On examination bleeding from the ears was observed. ‫ كسر بقاع الجمجمة‬-‫)أ‬3( ‫ اصابة بالرأس‬-‫ب‬ ‫ ل يوجد‬-‫ج‬

1(A middle aged man was driving along a road , where the car curved and crashed into a tree, he was found dead at the wheel , autopsy revealed fracture ribs , hemothorax, rupture of the thoracic aorta ,also coronary arteries were moderately atherosclerotic.

‫ اصابة بالصدر‬-‫)أ‬2( ‫ ارتطام بعجلة القيادة‬-‫ب‬ ‫ حادث سيارة‬-‫ج‬ ‫) تصلب الشرايين التاجية‬2(