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ACTA DE LEVANTAMIENTO DE CADVER

I.

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

II.

INFORMACIN DEL AGRAVIADO / OCCISO

1.

Nombre y apellidos del agraviado / occiso.

__________________________________________________________________
__________________________________________________________________

2.

Edad aproximada: __________________________________________________

3.

Documento de Identidad ( tipo y nmero) ________________________________

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III.

DIVPOINV DEPINCRI
SEC. INV. DCVCS/F

DEL LUGAR DE LOS HECHOS

Descripcin del occiso:
Posicin del cadver ____________________________________________________
_____________________________________________________________________
Ubicacin del cadver ___________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Describa la ropa que tena puesta el occiso (estado, color, No. de bolsillos, tipo de
prenda):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
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:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
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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SEC. INV. DCVCS/F

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Otras:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
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. __________________________________________________________________
12. _________________________________________________________________

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Enumere y describa, segn su relevancia criminalstica, lo siguiente:

Detalle (Tipo, encontrado en, caractersticas, ubicacin en la
escena y en relacin al occiso)
Vestigios

Huellas

Objetos

Instrumentos
(Cortantes,
Constrictores,
contundentes)

Bienes
(Dinero, joyas,
ttulos
valores,
tarjetas de
crdito)

Otros.

Otras observaciones relevantes:

1. __________________________________________________________________
2. _________________________________________________________________
3. __________________________________________________________________
4. _________________________________________________________________

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5.
6.
7.
8.
9.
10.
IV.

DIVPOINV DEPINCRI
SEC. INV. DCVCS/F

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
__________________________________________________________________

DIAGNOSTICO PRESUNTIVO DE MUERTE (Determinar causa bsica y causa

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

V.

JUSTIFICACIN DEL REQUERIMIENTO DE NECROPSIA \ IDENTIFICACIN.

(Art.196 NCPP)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

--- 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: _________________________________________________________

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DIVPOINV DEPINCRI
SEC. INV. DCVCS/F

Firma: ____________________________

Firma: ____________________________

Cargo: ___________________________

Cargo: ___________________________

Firma: ____________________________

Firma: ____________________________

Cargo: ___________________________

Cargo: ___________________________

Firma: ____________________________

Firma: ____________________________

Cargo: ___________________________

Cargo: ___________________________