OFFICE OF THE MEDICAL EXAMINER FLORIDA, DISTRICTS 7 & 24 VOLUSIA & SEMINOLE COUNTIES 1360 INDIAN LAKE ROAD, DAYTONA BEACH, FL 32124-1001 MEDICAL EXAMINER REPORT Name Martin, Trayvon Medical Examiner # — 12-24-043 Date of Birth — February 5, 1995 Date of Death (Found) February 26, 2012 Age 17 Years County Seminole Race Black Date of Exam February 27, 2012 Sex Male Time of Exar 1030 Hours FINAL DIAGNOSES AND FINDINGS 1. Penetrating Gunshot Wound of the Chest A. Entrance: Left chest, intermediate range B. Path of the projectile: Skin, left anterior 5 intercostal space, pericardial sac, right ventricle of heart, and right lower lobe of tung ©, Direotion of projectile: Directly, front to buck D. Exit: None; fragments of projectile recovered in pericartlial sac and right pleural cavity FE, —_Associated injuries: Entrance wound; perforations of pericardial sac, right ventricle of heart, sight lower lobe of lung with bilaterel pleural hemorrhage F. Postmortem radiograph: Metallic fragments of projectile identified Cause of Death: Gunshot Wound of Chest Manner of Death: Homicide How incident oceurred: Shot by another person Zz, ZZ Ovi, 2, 35 ue (2. Shiping Bao, M.D. Associate Medical Examiner XC: State Attorney's Office Sanford Police Department "Gecnedited By the Nationak Cesaciation of Medical Examiners”OFFICE OF THE MEDICAL EXAMINER FLORIDA, DISTRICTS 7 & 24 PAGED 8 Name Martin, Trayvan ME# 12-24-0438 MEDICAL EXAMINER REPORT REPORT OF AUTOPSY OFFICIALS PRESENT AT EXAMINATION None. EXTERNAL EXAMINATH ‘The body is secured in a blue body bag with Merlical Examiner scal #0000517. ‘The body is viewed unclothed. The body is that of a normally developed, black male appearing the stated age of 17 yours with a body length of 71 inches and body weight of 158 pounds. The body presents a roedium build with average nutrition, normal hydration and good preservation. Rigor mortis is vompleis, and lividity is well developed and fixed on the posterior surfaces of the body. ‘The body is cold to touch post reftigeration. Short black hair covers the scalp. The face is unromarkable. ‘There is average body hair of adult-male-patter distribution, The eyes are closed ‘and have clear bulbar and palpebral conjunctivac, ‘The irides are brown with white solerse. There are mo cateracts or arcus présant, ‘The pupils are equal at 5 millimeters, The orbits appear normal, ‘The nesal cavities are unremarkable with an intact septum. The oral cavity prevents natural teeth with fair oral hygiene, The eats are unremarkable with no hemorshage in the external auditory canals. The neck is rigid due to postmorten changes, and there are no palpable masses, The chest is symmetrical, The abdomen is scaphoid, ‘The upper and lower extremities are equal and symmetrical and present cyanotic nail beds without clubbing or edema, There are no frectutes, deformities or amputations present, The external genitalia present descended testioles and an unremarkable penis, The back reveals dependent lividity ‘with contact pallor. The buttocks are atraumatic, and the anus is intact, ‘The integument is of normal color. OTHER IDENTIFYING FEATURES ‘There are identification bands on the ankles. SCARS ‘© Lx 4ineh soar - right shoulder + 1x Minch sear - right hand TATTOOS © Symbol with letters - right ann © Letters - left wrist There are no other significant identifying features,OFFICE OF THE MEDICAL EXAMINER FLORIDA, DISTRICTS ? & 24 PAGE Les Name Martin, Trayvon ME# 12-24-043 MEDICAL EXAMINER REPORT REPORT OF AUTOPSY EVIDENCE OF INJURY Penetrating Gunshot Wound of the Chest: The entrance wound is located on the Jeft chest, 17 inches below the top of the head, 1 inch to the left of the anterior midline, and %4 inch below the nipple. It consists of a % inch diameter round entrance defect with soot, ting abrasion, and a 2 x2 inch area of stippling. This wound is consistent with a wound of entrance of intermediate range, Further examination demonstrates that the wound track passes directly from front to back and enters the pleural cavity with perforations of the left anterior fith interoastal space, pericardial sac, right ventricle of the heart, and the right lower lobe of the lung, There is no wound of exit. Three fragments of projectile are revovered, The leed core is recovered in the perieacdial sac behind. he right ventricte. Two fragments of the jacket are recovered in the right pleural cavity bohind the ight lower lobe of the lung. ‘The injuries associated with the wound: The entrance wound; perforations of left anterior fifth intercostal space, pericardial sac, right ventricle of the heart, right lower lobe of the lung with approximately 1300 milliliters of blood ia the right pleural cavity and 1000 in the left pleural cavity, the collapse of bath lungs, ‘Other injusies: There is a 4 x Y inch small abrasion on the left fourth finger. EVIDENCE 0) INT. MEI ‘There is a cardiac monitor pad on the left flank. EVIDENCE OF ORGAN AND/OR TISSUE DONATION None. INTERNAL EXAMINATION: ‘The following excludes any previously described Injuries, BODY CAVITIES ‘The peritoneum is congested, smooth, glistening and essentially ary; devoid of adhesions or effision. There is no scoliosis, kyphosis or lordosis presont, The left and right diaphragms are in vir normal location and appeat grossly unremarkable,OFFICE OF THE MEDICAL EXAMINER. FLORIDA, DISTRICTS 7 & 24 Pace acre Name Martin, Trayvon MEA 1224-043 MEDICAL EXAMINER REPORT REPORT OF AUTOPSY The subcutaneous fat measures 1,5 centimeters and is normally distributed, moist and bright yellow. ‘The musculature of the chest and abdominal area is of normal color and texture. NECK AND TONGUE ‘The neck presents an intact kyoid bone as well as the thyroid and cricoid cartilages. The larynx hus unremarkable vocal cords and folds thet appear widely patent without foreign material, ‘The epiglottis is a characteristic plate-like structure without edema, trauma or pathological lesions. Both ‘the musculature and the vasculature of fhe anterior neck are unremarkable, The trachea and spine are in the midline, and present no traumatic injuries or pathological lesions. The tongue is oremarkable, CARDIOVASCULAR SYSTEM ‘The heart weighs 200 grams and there is no chamber hypertrophy or dilatation, The left veatsicular wall is 1.1 centimeters and the right is 0.2 centimeters. The cardiac velves appear unremarkable, The coronary ostia are in the normal anatomical location leading into widely patent coronary arteries, Right dominant circulation is present. The endocardial surface is smooth without thrombi or inflammation. Sectioning of the myocardium presents no gross evidence of ischemic changes cither of recent or remote origin. The artic arch, slong with the great versels, appears grossly ‘unremarkable, ‘RESPIRATORY SYSTEM ‘The lungs are collapsed and together weigh 410 grams. There are no grose pneunonic lesions or abnormal masses identified. The ttachenbronchial tree and pulunonary arteriel system are intact and grossly unsemarkable, The pleural surfaces are pink and smooth with focal mild anthracosis, HEPATOBILIARY SYSTEM. ‘The liver weighs 1110 grams and presents a browa, smooth, glistening surface. Focal patehy yellow discoloration, due to mild fatty metamorphosis, is present, On sectioning, the hepatic parenchyma is yellow-brown, homogeneous and congested, ‘The unremarkable gallbladder contains epproximately 8 milliliters of greenish bile, There is no cholecystitis or lithiasis. The biliary tree is patent. The pancreas presents a lobulated yellow cut surface without acate or ehronie pancreatitis. HEMOLYMPHATIC SYSTEM ‘The spleen weighs 100 grams and presents a pray-pink intect capsule and a dark red parenchyma, There is no lymphadenopathy. Tae thymus gland is involuted.OFFICE OF THE MEDICAL EXAMINER FLORIDA, DISTRICTS ? & 24 aes Name Martin, Trayvon ME 12-24.043 MEDICAL EXAMINER REPORT REPORT OF AUTOPSY GASTROINTESTINAL SYSTEM The esophagus is intect with normal gastroesophageal junctions and without erosions or varices. ‘The stomach is also normal without gastritis or ulcers, and contains 400 milliliters of gastric fluid ‘with food particles. Loops of small and large bowel appear grossly unremarkable, The appendix is unremarkable. UROGENITAL SYS ‘The kidneys weigh 100 grams, and 110 grams, right and left, respectively. On sectioning, the cortex presents @ normal thickness above the medulla, The ronal columns of Bertin extend be:ween the woll-demarcated pyramids and appear unremarkable. The medulla presents noymal renal pyramids with unremerkable papillae. The pelvis is of normal size and is lined by gray glistening mucosa. ‘There are no calouli. The renal arteries and veins ere normal. ‘The ureters are of nonmal caliber lying. in their course within the retoperitoneum and drain inte an unremarkable urinary bladder containing. approximately 75 milliliters of urine. The external genitalia present an unremarkable penis without hypospadia, epispadias or phimosis. ‘There are no infectious lesions or tumors noted. The descended testicles are of normal size encased within an intact and watemarkabie scrotal sac. There are no abnormal messes or hemias on palpation. The prostate is of normal size and shape and sectioning presents two normal laters) Jobes with @ thin median lobe forming the floor of the unremarkable urethra. There are no gross pathological lesions. ENDOCRINE SYSTEM ‘The thyraid gland is of normal size and shape and presents two well-defined lobes with « connecting isthmus and a beefy-brown cut surface. ‘There are no goitraus changes or adenomas present, The adrenal glands are of normal size and shape. Sectioning presents no gross pathological lesions. Mus KELETAL, ‘The ribs, stermum, clavicles, pelvis and vertebral column have no recent fractures, The muscles are nonmally formed CENTRAL NERVOUS SYSTEM ‘The scalp is intact without contusions or lacerations, The calvarium is likewise intact without bony abnormalities or fractures. ‘The brain weighs 1400 grams and presents moderate congestion of the leptomeninges, ‘The overlying dura is intact and unremarkable. The cerebral hemispheres reveal a normal gyral pattern with severe global edema. ‘The brainstem and corebelli are normal inOFFICE OF THE MEDICAL EXAMINER FLORIDA, DISTRICTS 7 & 24 eee Name Martin, Trayvon ME # 12-24-043 MEDICAL EXAMINER REPORT REPORT OF AUTOPSY appearance with no evidence of cerebellar tonsillar notching, The circle of Willis is patent and presents no evidence of thrombosis or berry aneurysm, Upon coronal sectioning of the brain, the ventricular system is symmetrica} and contains clear cerebrospinal uid. ‘There are no space- ocoupying lesions present. The spinal cord is not examined. MICROSCOPIC EXAMINATION: One slide examined on March 15, 2012, HEART: No diagnostic abnormality, LUNGS: The pavtiat collapse of tissues, LIVER: No diagnostic ebnormality. TOXICOLOGY: Soe separate report from NMS Laboratories. SB End of ReportOffice of the Medical Examiner, Volusia County Nome: UMDENTIFIED #, Cree Number 2012-24049 Age: ace: Black Sex Nato AM R2 ¢ _) oe “eounch Fann He oy But shoplia feu ihe mal hv wpe | bt Aint 5™ | mere ho CersSprw | me"? act | 2 coo Va pf TP at Ror Covel Save fe, Ror of @r Vea, abe sac y e wee ASE a Bere fe ee Re Lbole bay (BEA fin Caryate eee eee es ave selopa Usa Weg aol ay ee [via Anse wee cna Peal Peer \ Cre. eetieres ec hkl ld er ie) 2 Seg Uakeboaba Tete Pes ee ae eee ra eee ete pai ee en eee anor es cs Ce en ene aera Cara Fai rca Har eee eres ieee PRE tans ieee ae eet eas or ens eae Lee re! ame ieSEMINOLE COUNTY MEDICAL EXAMINER'S DEATH REPORT SUICIDE oO ACCIDENTAL OG NATURAL ___ HOMICIDE oN dare AAD ID | the: 2.900. Deputy: Se cuen YPILWO I T, subjects Lax Hames LOE Freinane: Octeas [mt 008 > FOEIS | nae CA ben ge a | Addrean: AID SRS MAI) Prone:( ) Noxtor kee Cf ehaemj> i Roteonati Prone ( p00: 4 AP}. Aeptorimata TOO: / PFO _| Pronounoad Bn SHIA Letecr FP” | Deadon Anival Emargoncy Room Daath Ask ER personnal fs natn Place of Danth (be name anu ment acess of tity, nti, ascence o sPo4y ated Bonn) Psrpowy (200 elves Phone: ¢ ‘Sign Gartiente: YES NO amity Physicin ute): Usk Disposed none Cops Funeral Hema: We Phone:() Lat Te Dcnnted We Seon Nor 9/5 EA ey on: Or Ey rtenahr¥ Oe Ope Me ite pe Se cet Yaa te/ Sean? o “Texenuan are COUNTY RESIDENT: veo Wo Gen Bain venignor —S0Ueee ceuusranore naouxoNe pen SHOT fet Curt Be Lard forgo. Date of Iniary [rine ot airy, [yun twos ves 0 NOD aoe of jury (Stowt Fooly, Hams, ofc): Location (Exact chess) Describe How inlury Occurred (White) M.Es Offee (Cananp 8.0, (€inig Funoral Home REVISED (12704)Mie Natitiow Date: Mr. Noutied Teme: Oe | MLE. Notified By et Reta }VESTIGATION BY MEDICAL EXAMINER City of Death; County of Death: Office of the Medical Examiner County of Volusia 1360 Indian Lake Road Daytona Beach, Florida Decedent;_ VN Wises Na Tas Wome Salix Grr HY Address Bees Bip, Sate ip Code age! | pow: (Female C Unknown Occupation: Race: © White O Bl American © Hispanic 0 Other Marital Status; Single 0 Married ODivorced SSNz TYPE OF DEATH (Initial Jurisdiction - Check only oy D Accident - Traffic Other 1D Violent - Other {yf U.Non Violent - $i ‘Suspected SIDS / (Or Infant) Police Custody - Jail/Prison Notification By: Address: Phone:, Tavisdiction’ ORT TAST SHIN ALIVE | INsURYTLLNESS rou DEATINPRONOUNCRD ____ DESCRIPTION OF PREMISES. 2 Tliowse © Apartment Mobile Home Workplace CHoteUMaiel GAG Home OFighway Retail Eablshmnent School © Hospital Cail 2Restaumn’Bar OPIyking Lot “City Park Woods Area CiFaim Pastve 1 Preshvaler River Seine my etanion Pond Ovean Ecaua Wuveny aisionbg tat Gomer oat, AE WA [Citoase © Apartment OMobile Home O Workplace GHotel/Moiel WAdut Home C Highway [Retail Establishment © School C Hospital (Jail “DRestaucmavar cPAyking Lot City Park Wooded Area fame Passe Freshwater River OF ref CRetention Pond C Ocean | wh Waterway 1 Swimming Pool ORegeh_ 3. oube SUE Sighatute of Medical Examiner / Forensic investigatorNARRATIVE DESCRIPTION OF CIRCUMSTANCES SURROUNDING DEATH: NEXT OF KIN INFORMATION: [ Name: Relationship: Addeess: | Telephone: DateTime of ME Arson ONT sence orOffice of the Medical Examiner, Medical Examiner Case Report Year: 2012 Notification By; Number: 24043 Date Reported: Emergency Communications Conter Investigative AgencyiJurisdiction; Sanford Poilce Dept 21672012 8: ECSCAD# 42.0570199 Decedent: Martin, Trayvon Age: 17 Race: Black Sex MALE Dato of Birth: 215 1095, Method OF 1D: Permanent Address: Shy: Miami State: FLORIDA Zip: Lost Seen Alive: 2/26'20127:16:00 PM By Whom: Residentof complex InPolice Custody?: NO Found? NO Date/Time of Death: 2/26/2012 7:30.00 PM Place of Death: Courtyard behind [J Retreat View Circie. City of Death: Sanford County of Death: Seminole Date of Injury: 22612012 7:20:00 PM Injured at Wark? NO Place of Injury: Couto behind | Retreat View Cicle Next of Kin: Funeral Homo: Mr. and Nis. Martin, Parents Investigating Agency: Sanford Police Dept Law Enforcement Case # —2012-50001136, investigator: Serine ME, investigator: Tare Malohurs Autopsy? Yes Modo of Death: Cause of Death: Examination Date: 2/27/2012 10:20:00 AM Handgun ‘Gunshot Wound of Chest Other Significant Conditions: Manner of Death: Homicide Doctor Signing DC: Shiping Bao, MD. Page 1 of 2 Country: USAYear: 2012 Number 24043 Decedent: Martin, Trayvon Caso Summary: ECC contacted F| Malphurs of an apparent death In Sanford in the courtyard behind [if Retresl View Circle, Person of contact (POC) was SPD nv. Serino. POC advised of an Unknown B/M who had been shot by & Tealdenl of the complex POC stated the folowing: At appranimetely 1010 haurs on 02/26/2012, 811 dispatchers received a call from 2 resident of the complex. ‘The resident advised of @ BIM who was al the complex between the townhouses. The caller stated that the male shauld not have been in the area and he observed the male while walking his neighborhood waich, Shortly after the call te resident confronted the male and the two began to pysically fght. Witnesses ‘observed the two fighting n the yard end then the resident fired a handgun at the male striking hie In the taheet. The mele fel lo the ground. SPD and SFD arrived on scene. The male was pronounced at 1930 hous. ‘The identity of the male was unknown. FI Malphurs responded to and anived on scene at approximately 2144 hours. Fi Maiphurs aboerved & Bit Iving fave up onthe ground in the courtyard, The male wes clothed wearing a swealshi, shir. pants anc ‘hos, The male didnot have identification in any of his pockols. The contents of the pockets ware teken into ‘custody by SPD. One (1) defect was seen onthe male's chest wth @ hot in each of he shits, SPD dd not request to vompicte a GSR ki POC sdviead that the weapon used Was a.9mm handgun. Fingerprint Identification was attempted: however, the mals was no inthe databace of ingerprints, The male was thon hnarned as Unidentiies #3, Photographs ofthe scene were taken. Livery aived on scene for assistance and placed theBM ins blue transport pouch. The pouch was sealed with blue tag #VCMEQ000517. Livery femoved the 8! to the MEO. POC was given a 1000 hours examination ime for 02727/20%2. Fl Mapu ‘leared the scene at approximately 2210 hours. TSM ‘Addendum: On 02/28/2012 at approximately 1230 hours, Fl Malphurs received 2 fax from Sanford Police Department confirming positive identification as: Trayvon Martin, 17yoa B/M, DOB: 02/05/1806. The Identification was made by his father from a crime scene photograph, ECC and MEO staff were notified and ‘an Wentication sheet was compiated. TSM Description Volum Specimen ruc 15epme het Bod [rHe-co0H (toy) 73 ag he thot Comins Yresone Po hee Page 2 of 2MEDICAL EXAMINER'S OFFICE DISTRICT 7 AND DISTRICT 24 IDENTIFICATI Ist Medial raniner Cane DEMIS defies As: _\ YIN Val Pe WISHS Agoracersex: YT Previously Listed As: . An bon 1. METHOD OF IDENTIFICATION: : MANNER GF IDENTIICATION’ ingerprint Report [Dental X-Ray ‘Antemortem X-Ray Photograph Viewing | Direot Viewing of Remains DNA Analysis { Eee Law Enforocinent Positive Mentfication Piesuraptive ID (Manne:) — Other IL CHANGES MADE TO FOLLOWING FILES /DOCUMENTS: ESTE GABNG EM ES ToS [BYINVESTIGATOR Tavestigators Case Log (call BCC, update CAD) Database Entrewiny Pile Paperwork [Haw Enforcement Agency Notified z é ‘Staff Notified (-mail) aa | Case Tracking Board (Hallway) [Update Unidentified Log Sheet (Hallway) [Fill Jacker/in ‘Autopsy (loyes) Other ReporsDO Workaheet Dy, —| Book of Death logy Reports (Gf specimens outto Lab) | —— ea Decedont Identification Tags ieee (aeeca ‘Transport Pouch/Body Beg Personal Fffects Sheet Toxicology and Histology Requisitions Gt ‘specimens not out to Lab yet) Morgue Traoking Bourd GAPORMSIi6_checkilst_form2_revised april 29 2010.doena Me CADE STM crry: Sain) \ ERO CASE pe Sw \ep counry:< Ny uo: ~ contact «-xunarn: |W: Suny ae we AY ww 5 pow AGR: MALE FEMALE SSN: WHITE BLACK r ADDRESS: 2 My os ADDRESS OF vean fer Vas M (GAME) LAST SEEN ALIVE DATE & TIME: \A \§ WHOM: INJURY OR ILLNESS DATE & TIME: (Mm PREMISES: FOUND DATE & TIME: WHOM: DEATH DATE & roe. {Ke in PRONOUNCED BY WHOM: oh LARGE PERSON; DR, SIGNING DC: MEDICAL HISTORY: Rigor/Lividity *48**NEXT OF KIN: ADDRESS: ( PERTINENT INFO, NOTESt bin ah tele, Soma dn or, 1 00 4 wala AL, tonbarba, Soin OutOFFICE OF THE MEDICAL EXAMINER District 7 and 24. Volusia and Seminole Counties (Vat Tay uoryeey PERSONAL EFFECTS NAME OF pECEDENT:SemtoENTTHe AE ‘CASE NUMBER: 2012-24088 me re _/1_ omrerecene 21/tne — wenronieven OC LUST OF DESHOENTS CLOTHING AME PERSONAL EFFECTS | eanironemousecoxt {Foss on tier omen reves LINGHTCOMVOR PALAIS 1 )BLOUSE OR SHAT ime a Cysuppers ones (| SKIRT Lfincker ~heceie U. lai a enmiaas aneee hae jac 116% efeants Lswearen 4—_____ tisur { )sH0Rre (amar 1 PERSONAL: Jithwensinnr og TSA? — | 1eLovEs ese Likeys (1reuer semeuey u I ywatter on purse Hreoca. scour om apie u (1c0Ms Cronwvers License isa “1 Coan Te (i aceceeseeeEat 0. NAIL cLPPERE "1 0 Lypocker knee 0 0 [ JHANOKERGHIER u. Licasses «K A Torne) LeARANC ee { penranes ‘yctool "1 eu prone aver to u [oeareres Le o o Cee 1 ustTe MONEY Lit he number ofebeh denaninalion BLS $100 310 CONS $1.00 so Dt 350 epee eee eee 50 ie eeeeeeeee lop 320 3 sa Ls roms!" Persona sony sy epee ruerannoue Aveel) uel. pate: 225 VU re: PZ onmm sronerune : sete i f MEO. STAFF & eaeMedical Examiner's Office District 7 and 24 1360 Indian Lake Road Daytona Beach, Florida 32124 Evidence Accountability Sheet Dkr FiED tS [MECH Jg-n9- OPE 4 MEDICAL EXAMINER: §, Go INVESTIGATOR CLARA i DATETIME COLLECTED: 9.3/3 7/A ose TECHNICIAN: {5 5 ber) EVIDENCE CLOTHING ‘CURRENCY (Bitsy [Gunshot Residue “ExShoes | [) Socks 1715100.00x (2 Head Hair Standards Eftagke. sweater | itis | £1 $50.00 Har ‘Z| Pubic Bair Standards Ty shire 1] (1 820.00% | | Co RaivFibers Recovered CiDress E] Skiet 1)510.00x [A Fingernail Serapings ” py, | [Pants C1 shorts (Cs8.00 7 (J Fingernail Clippings Penis [O50 (81.00% se ‘T]Anal Swab C)Dentures | C) Left (Coin) 7 [7 Anal Smear t “MISCELLANEOUE Osx | F1s50% Cys25% Osx T "Veginal Smear Di Necttace Os0sx ee Pipiood FT a Lisoix [ ZiProjecite 4 eragrent | TOTALS etree Fingerprints c ZPhowoicd c Relensod by: (printisign) @ (Sor hor Agency: VC. /4. &. 0, | Received By: (printisigm)) Si" “sy gag 8 Date/Time Received: oy foe jig se Agen DaterFime Released: | Recelved Bys (print/sign) flicentsicdD - | Date/Time Received:Medical Examiner Transport for District 7 and 24 DECEASED'S VALUABLES AND PERSONAL PROPERTY RECORD nave Sad ford Pub. pie 26-19) team pm Fu vowe of Deseo tal a, HS remot ates 263) Re tf bs Se A ase 4; & sx fA tnot [QOS Jal FF oo row BED coer 18°79 473 sso aoe eens BLO @ — rivets soe 2290 depute TOI am Gave 00 AI VOD poe, Repor( ) Charts( Meds () Blood) Urine( wave cuoras reat eet Peete ag Abeer gee ea ae Se & ° Fa Dress loose Skit eerie sale eee Peeeeeeeeacaae Sor a Sect = eevee ae eee Pine oo Pees “TE Property Released To: Poliee( —) PAPC) M.E.OMice( ) Homp.( me tS # aoces/? flack hAEC4 Potice Dept:-SAnnd (24 D County: «Staind wi AY : IN WITNESS THEPOF: THe UNDERSIGNED HEREBY ACKNOWLEDGES THE ABOVE MENTIONED ITEMS FULLY AND ACCURATELY REPLECTS THOSE BELONGMNOS OF THE DECEASED, FOUND IN HIS/HER POSSESSION AT THE TIME OF TRANSFER BY MEDIC COD ep, SERVICE. siennee X sestroO wonacto ey WO von WKS | nen SSAA venue 4C, 7OFFICE OF THE MEDICAL EXAMINER Districts 7 and 24 DEATH CERTIFICATE WORKSHEET -~ sven rmacdies, Treyuen name: UNBeNT@IeD Ha neon mre Aas: |? Dele of ith: RSS Boe M ‘Race: Bleck Reséon,, LORIOA Aaenon Seto Potce Dept cas zoiegoottee Place of Dean; CouryerdbainRetaa: View Clo Dale feat ano 3000 PM round a (chechomy — thaopay Patra sama son Ony Rass Ravi Oy Dae cternirnon 2/2 7/207 2 time otéiantatin JOSS pou cuscorseie Gfunshut Would of Chest isto ust Other Stnicant Condos: wise | wed [ome [oe par [tne [ee [oe | oe [oe | oe seit eff — J | ae |e [ronoe [8H Mex [Din [Oe ]vB [16 [16 Min fori Bes Proto: des No Rays fen No denitaton: ¥e8 __Pordlng Infant Lotter Noeded _ Yes _.Noone: 972-267-6277 Fax: 672-241-8747 {nat tasvotachpatology.com Volusia County 4360 Indian Lake road Daytona Beach, FL 32124 Phono: 386-256-4060 District 24 (Seminole) Histology / Autopsy Requisition Form CasoNo: (2-24-03 Name: Lest ward ewi7 fred (3 First Patrdogst, — Caa0_ Aaopsy Assen he are: aeqhow Casctiss | Specal Sti /rstuctlons Cini! rematon B. ea tee Desens australe 1 Ido | pox by Tene TDYKY #ofCass. Reon : FofBlocks, —/ —HofSilides, / Rad, by Tissue Tech OAT, 3-7-2 Hof Blocks Hof Sides, Reo, by ME staff ONE, St /B-/2-{50re eae ee. 100 ‘hue Besse Daytona Beach, FL 32124 Phone: 386-268-4060 District 24 (Seminole) JLstve Techniques Volusia County ee Serenata 1380 Indlan Lake road al tesuetocnpstnslogy.com Histology / Autopsy Requisition Form CaseNo: /2-24-O¥3 Name:_Last uu DEN TIF 5, Fist DATE: arian Pélidogst 2.0 aby stat Doha Naber oF [issu Type Casteles | Spaciel Stans / Instructs (incl infomation ‘ J ¢ # Witdess, | WE: Za wre Rel by ME sla DS mre alag] Hof Cass, Recy, RecbyTissue Tech DATE: te FOBlocks: HofSldes; Rel by Tissue Tech DATE: fof Blocks: HfSides: Rev. by ME st DATE: fe