---

📚 Complete Study Notes: Legal Procedures & Provisions in Nepal

---

🔑 TOPIC 1: What is Medico-Legal?

• It is needed in cases involving crimes against the human body
• The doctor prepares evidence through examination
• That evidence helps the court make decisions

Memory trick: Medico = Medicine + Legal = Law. It is where Medicine helps the Law.

---

🔑 TOPIC 2: Laws Regulating Medical Practice in Nepal

---

🔑 TOPIC 3: Muluki Criminal Procedural Code (Ain) 2074 - Key Sections

Section 20 (Annex 15) - Death Cases

• Applies to: homicide, suicide, accident, unnatural death, suspicious death
• Police investigator documents details at the scene of death
• Body is sent to a government doctor, licensed doctor, or government-designated specialist
• Report prepared in Annex 15 format
• Specialist can be taken to the scene by the investigator

Section 21 - Physical Evidence Analysis

• Investigation officer can request a government doctor or authorized lab to examine:
  • Blood, hair, semen, body organs, weapons, DNA, and other objects linked to a crime
• The concerned individual must cooperate and provide samples
• Examination report must be prepared by the hospital/lab

Section 22 (Annex 16) - Injury Examination

• Used in cases of physical assault
• Examination done by a government doctor using Annex 16 format
• Also used when a court orders examination of a detainee (e.g., torture allegation cases)

⏰ Important Time Limit:

Report must be submitted to concerned authority within 3 days (for Sections 20, 21, and 22)

---

🔑 TOPIC 4: Medico-Legal Examination Formats

Key Rule: All formats must be prepared by the hospital/doctor - NOT by police!

---

🔑 TOPIC 5: Structure of a Medico-Legal Report

A. Preamble (Introduction) Part

• Case registration number
• Name of patient
• Age and Sex
• Who brought the case (police/court)
• Consent for examination
• ID marks
• Date and time of examination

B. Body Part of Report

• History of the incident
• Medical history
• Examination and findings in detail
• Look for:
  • Any medical conditions?
  • Any injuries? (causation, time of injury, severity)
  • Other associated conditions

C. Conclusion/Opinion

• Opinion on general physical or mental health
• Opinion on injuries (if present)

---

🔑 TOPIC 6: How Should a Medical Examination Be Done?

• Authorization - letter from the concerned office must be present
• Person must be free from restraints
• Written informed consent must be taken

Important Q: Can force be applied during examination? NO - never!

• Proper examination room with necessary instruments
• Age estimation if needed
• Strict confidentiality must be maintained (separate room)

---

🔑 TOPIC 7: Inquest

4 Types of Inquest:

---

Police Inquest (Nepal's Most Common)

• Done by police - not below the rank of Head Constable
• NOT required to mention: accused, alleged weapon, or witness
• If there is a discrepancy between inquest report and postmortem report → postmortem report wins

---

Magistrate's/Court's Inquest - When Is It Done?

• No person is unjustly deprived of liberty
• No person in custody dies due to neglect or brutality
• No doubt about identity/cause of death in buried cases

1. Deaths due to police firing
2. Death/disappearance in police custody or during interrogation
3. Death of a convict in jail
4. Exhumation cases (body dug from grave)
5. Rape alleged in police custody
6. Dowry deaths (suicide/death of a woman within 7 years of marriage)

Memory trick for 6 indications: "Police fires, Custody death, Jail convict, Exhume body, Rape in custody, Dowry death" = PC-JERD

---

Medical Examiner's Inquest (USA system)

• Done by a board-eligible forensic pathologist
• Visits scene of incident
• Performs autopsy
• Correlates findings with evidence
• Superior to non-medical inquests
• BUT: cannot examine witnesses under oath and cannot arrest anyone (no judicial powers)

---

Coroner's Inquest (NOT in Nepal)

• Coroner = advocate/attorney or 1st class Magistrate with 5 years experience, or Metropolitan Magistrate
• Appointed by state government
• Not practiced in Nepal

---

🔑 TOPIC 8: Deaths NOT Due to Natural Causes (Suspicious Deaths)

1. Sudden death
2. Suicide, homicide, infanticide
3. Death from accident, poisoning, drug mishap, machinery
4. Unexplained death, burns, fall from height
5. Death under anesthesia / on operation table / postoperative shock
6. Death due to medical negligence or within 24 hours of hospital admission
7. Death of a convict in jail, police custody, mental hospital, or correctional school

---

🔑 TOPIC 9: Summons / Subpoena

Priority Rules when Multiple Summons received:

1. Criminal court takes priority over civil court (but inform civil court)
2. If both from same type - higher court gets priority
3. If both same status - earlier received summons gets priority

---

🔑 TOPIC 10: Conduct Money

• If not paid or amount seems less → doctor can inform the judge, who will decide
• In criminal cases: No fee is paid at time of summons
  • Doctor must attend (state's interest in justice)
  • Refusing = contempt of court
  • But conveyance charges and daily allowances are paid

---

🔑 TOPIC 11: Courts in Nepal

• Local level judicial institutions can also be formed
• Alternative dispute resolution bodies can also be formed

---

🔑 TOPIC 12: Witness

Types of Witnesses:

Expert Witness - Key Points:

• Has special knowledge by practice, observation, or study
• Value depends on soundness of reasoning, NOT on qualifications
• Can draw inferences and give opinions

Hostile Witness:

• Willfully conceals truth or lies (due to bribe or intimidation)
• Statement contradicts their previous deposition (e.g., what they told police)
• Either common or expert witness can become hostile

---

🔑 TOPIC 13: Perjury

• Hostility is a form of perjury
• For perjury: BOTH the earlier statement AND the later statement must be on oath
• If both statements oppose each other and cannot be reconciled = perjury

---

🔑 TOPIC 14: Medical Evidence

Two Types:

1. Oral Evidence

• Statements made by a witness in court, permitted by court
• Must be direct (eye witness)
• More important than documentary evidence (allows cross-examination)

1. Dying Declaration
2. Expert opinion in treatise/textbook
3. Deposition from lower court
4. Evidence from previous judicial hearing
5. Statements by person who cannot be called as witness
6. Reports of government expert committees
7. Public records
8. Hospital records

2. Documentary Evidence

• Written or printed documents produced before court
• Includes:
  • Medical certificates
  • Medico-legal reports
  • Dying declaration
  • Expert opinions from books, depositions from previous hearings

Hearsay / Indirect Evidence

• Evidence where the witness has no direct knowledge but testifies based on what others said
• Related concept: Res-gestae (things done/said as part of the act itself)

---

🔑 TOPIC 15: Dying Declaration

"The fact expressed by a person, who is dead but who expressed it in the dying stage when he/she was in normal condition regarding to the cause of his or her death, may be taken as evidence."

Procedure for Recording Dying Declaration:

1. Doctor must certify the person is conscious and mentally normal
2. No oath is given (belief: a dying person tells the truth)
3. Ideally a Magistrate should record it
4. If death is imminent: doctor or police can record it with 2 witnesses present
5. No leading questions allowed
6. Recorded as a simple narrative - no alterations
7. If declarant becomes unconscious mid-statement - record whatever has been said
8. Fitness certified at the conclusion of the statement
9. Declaration sent to Magistrate in a sealed cover
10. If the person survives - declaration is not admitted as dying declaration, but has corroborative value, and person is called to give oral evidence

Other Important Features:

• Statements: verbal or written - both valid
• Must relate to circumstances leading to death
• Proximity between time of statement and death matters
• Multiple dying declarations are possible
• Incomplete dying declaration is still valid
• Need not be exhaustive

---

🔑 TOPIC 16: Dying Deposition (vs Dying Declaration)

---

🔑 TOPIC 17: Procedure for Examination of a Witness in Court

1. Oath - witness takes oath
2. Examination in Chief - by the party who called the witness
3. Cross Examination - by the opposing/defense lawyer
4. Re-examination - by the calling party again
5. Court Questions - judge can ask questions at any stage

---

Examination in Chief:

• Done by the party who calls the witness (in criminal cases = public prosecutor)
• Goal: place all relevant facts before the court
• No leading questions allowed (except when witness is declared hostile)

Cross Examination:

• Done by the defense lawyer
• Goal: weaken evidence by showing it is inaccurate, contradictory, or untrustworthy
• Leading questions ARE allowed
• No time limit (can last hours or days)
• Court can disallow indecent, scandalous, insulting, or offensive questions
• If a question is not understood - ask for clarification, do NOT volunteer extra information

1. Elicit facts favorable to defense
2. Test accuracy of witness statements
3. Modify/explain what was said
4. Develop new or old facts
5. Discredit the witness
6. Remove over-emphasis on any fact

Re-examination:

• By the party who originally called the witness
• Goal: clarify doubts from cross-examination; explain matters in proper perspective
• No leading questions
• Opposing lawyer gets right of re-cross-examination on any new point raised

Court Questions:

• Judge can ask any question at any stage to clear doubtful points

---

🔑 TOPIC 18: Conduct and Duties of a Doctor in Court (Expert Witness)

• Take all records and relevant reports
• Be well dressed and modest
• Do not discuss the case with anyone in court except your lawyer

• Never memorize - you are allowed to refresh memory from copies of reports
• Speak slowly, distinctly, audibly (for the typist)
• Use simple language - avoid technical terms
• Address the Judge as 'Sir' or 'Your Honor'
• Be polite and courteous to the lawyer
• Do not underestimate lawyers' medical knowledge

• Do NOT evade a question - say "I don't know" if you genuinely don't
• Do NOT lose your temper (angry witness = poor witness)
• Retain independence of mind - a biased expert is useless
• Listen carefully; ask for repetition if unclear
• Watch for double questions (each part may need a different answer)
• When commenting on a colleague - avoid insults; say "no opinion" if uncomfortable
• Say "In my opinion..." NOT "I think..." or "I imagine..."
• Stay within your field of expertise - do not speak on subjects with no experience
• Do NOT volunteer information beyond what is asked

---

🗂️ QUICK REVISION TABLE: All Key Numbers/Facts

---

🧠 MEMORY TRICKS SUMMARY

---

📝 TOP EXAM QUESTIONS (Long Question Topics)

1. Define Inquest. Describe the types of inquest. What are the indications for Magistrate's inquest?
2. What is a Dying Declaration? Describe the procedure and features of recording a dying declaration. How does it differ from a Dying Deposition?
3. Describe the structure of a Medico-Legal Examination Report.
4. What are the types of witnesses? Describe the duties and conduct of a doctor in court as an expert witness.
5. Describe the procedure for examination of a witness in court.
6. Describe the sections (20, 21, 22) of Muluki Criminal Procedural Code 2074 related to medico-legal work.
7. What is Medical Evidence? Describe the types with their features.
8. Write about Perjury and Hostile Witness.
9. What is Summons? What are the rules for priority when multiple summons are received?
10. What are the types of Courts in Nepal?

---

---

🪥 Dental Brushing Techniques

Quick Classification

---

Technique Diagram Overview

---

1. 🔵 Bass Technique (Sulcular Technique)

Most recommended & most widely accepted technique

• Place bristles at 45° angle toward the gum/root (apically)
• Bristle tips should enter the gingival sulcus (the groove between tooth and gum)
• Give short back-and-forth vibratory strokes (20 strokes per area)
• Move brush to 2-3 teeth at a time
• On front teeth (lingual side) - hold brush vertically, use heel of brush
• Clean biting surfaces with back-and-forth strokes

• Healthy adults
• Patients with periodontal (gum) disease
• Most commonly recommended by dentists worldwide

---

2. 🟢 Modified Bass Technique

Bass technique + a rolling/sweeping motion added

• Start same as Bass: bristles at 45° toward gum, enter sulcus
• Give a few vibratory strokes first
• Then roll/sweep the brush toward the crown (occlusal direction)
• Repeat for each group of 2-3 teeth

• General use for all patients
• Most recommended for everyday brushing

---

3. 🟡 Stillman's Technique

Bristles placed on gum + tooth, NOT inside the sulcus

• Place bristles partly on gum (gingiva) and partly on cervical (neck) area of tooth
• Bristles at 45° angle apically (toward root) like Bass, BUT do NOT enter sulcus
• Uses sides of bristles, not the tips
• Give 20 short back-and-forth strokes while slowly moving coronally (toward crown)

• Patients with gingival recession (exposed roots)
• Patients needing gum massage/stimulation

---

4. 🟠 Modified Stillman's Technique

Stillman's + rolling motion added (same upgrade as Bass → Modified Bass)

• Start same as Stillman's: bristles on gum and cervical area at 45°
• Give vibratory strokes
• Then roll/sweep toward the crown (coronally)

• Patients with gum recession AND root exposure
• Patients needing both sulcus cleaning and root surface cleaning

---

5. 🔴 Charter's Technique

Bristles point TOWARD the crown (opposite of Bass)

• Place bristles at 45° angle occlusally/coronally (toward biting surface, away from gum)
• Bristles point AWAY from gums, INTO the spaces between teeth (interproximal)
• Give short back-and-forth vibratory strokes
• Press bristles on biting surfaces with a slight rotary motion

• Patients with fixed braces (orthodontic appliances)
• Patients with bridges and crowns (fixed prosthetics)
• After periodontal (gum) surgery - gentle cleaning of healing wound

---

6. 🟣 Fones Technique (Circular / Rotary)

Simplest technique - circular motion with teeth closed

• Keep upper and lower teeth in contact (closed position)
• Place brush against the outer surface of teeth
• Move brush in large circular motions covering both upper and lower teeth at once
• Do 4-5 circles per area, then move to next section
• For front teeth - use smaller circles
• Also clean inner surfaces and biting surfaces

• Young children (easy to learn)
• People with limited manual dexterity
• Teaching basic brushing to kids

---

7. ⚪ Horizontal Scrub Technique

Simplest of all - just scrub back and forth

• Place brush against teeth
• Move in a simple horizontal back-and-forth motion
• No specific angle required

• Young children
• People who cannot learn complex techniques

---

Visual Summary - Modified Bass (Step by Step)

---

Summary of All Techniques - Quick Revision Table

---

📊 Comparison Table at a Glance

---

🧠 Memory Tricks

---

Bottom line: For most adults, Modified Bass is the gold standard technique. For children, Fones is easiest. For braces/bridge patients, use Charter's. For gum recession, use Modified Stillman's.