Child Justice Act, 2008 (Act No. 75 of 2008)

Regulations

Regulations relating to Child Justice

Annexure

Form 4 : Age estimation of child by medical practitioner

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Form 4

 

AGE ESTIMATION OF CHILD BY MEDICAL PRACTITIONER

SECTION 14 OF THE CHILD JUSTICE ACT, 2008 (ACT NO. 75 OF 2008)

REGULATIONS RELATING TO CHILD JUSTICE

[Regulation 15]

 

At the Preliminary Inquiry/

In the Child Justice Court held at


Case no/File no.


 

PART A

 

Personal particulars of child

Full names and surname


Sex


 

Particulars of parent, appropriate person or guardian or Child and Youth Care Centre

Full names and Surname / Name of Centre


Contact details of person / Centre


Physical address of person / Centre

 

 

 

 

 

PART B

REFERRAL OF CHILD TO MEDICAL PRACTITIONER

 

TO: Particulars of medical practitioner

Full names and Surname


Particulars of hospital or practice


Contact details



 

Since there is uncertainty as to the age of the child mentioned above, the child is referred to you in terms of section 14(2)(d) of the Child Justice Act, 2008 for an estimation of age.

 

 

......................................................................

Signature: Presiding Officer

Date:

 

 

PART C

MEDICAL ASSESSMENT OF CHILD

Height



Weight



Condition of:

Face



Lungs



Heart



Teeth



Sight



Hearing



Speech



Bone structure



Neurological state



Intellect


Any diseases, infection, injuries or impairment (Indicate degree)



Nutrition

Adequate/deficient.

If deficient, provide details


Vaccinations

Yes/No

If yes, provide details


Physical development

Normal/abnormal.

If abnormal, provide details


Sexual organs

Breasts



Pubic hair



Genitals



Auxiliary


Substance abuse

Yes/No

If yes, provide details


Other Observations

Provide details


Medical or other treatment required/ recommended



 

Remarks

 

....................................................................................................................................................

....................................................................................................................................................

....................................................................................................................................................

....................................................................................................................................................

 

Opinion/conclusion

Based on the above-examination and the child's general appearance—

(a)

The age of the child is assessed at being between .................... and ............. , the most probable age is ..............

(b)

The possible date of birth could be ...............................................................

 

 

...........................................................................

Signature: Medical Practitioner

 

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DateOfficial Stamp