Part 2 continued
14. Please give the full name and address details of any person who nursed the deceased during their
last illness (Say whether professional nurse, relative, etc. If the illness was a long one, this question
should be an swered with reference to t he period of four weeks before the death.)
15. Were there any persons present at the moment of death?
If Yes, please give the full name and address details of those persons and
whether you have spoken to them about the death.
16. If there were persons present at the moment of death, did those
persons have any concerns regarding the cause of death?
If Yes, please give details
17. In view of your knowledge of the deceased’s habits and constitution do you
have any doubts whatever about the character of the disease or condition
which led to the death?
18. Have you any reason to suspect that the death of the deceased was
19. Have you any reason at all to suppose a further examination of the
body is desirable?
If you have answered Yes to questions 17, 18 or 19 please give details below:
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