A dying declaration was taken from a victim (NAME) at Angeles Medical Center on (DATE) at around (TIME) in the presence of two witnesses and an investigator. The victim stated that he/she had been shot and identified who the shooter was in response to questions from the investigator. The doctor then pronounced the victim deceased at (TIME), ending the dying declaration.
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Dying Declaration
A dying declaration was taken from a victim (NAME) at Angeles Medical Center on (DATE) at around (TIME) in the presence of two witnesses and an investigator. The victim stated that he/she had been shot and identified who the shooter was in response to questions from the investigator. The doctor then pronounced the victim deceased at (TIME), ending the dying declaration.
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE ANGELES CITY POLICE OFFICE POLICE STATION 5 Friendship Highway, Barangay Cuayan, Angeles City SUBJECT
DATE
First Progress Report - Re Shooting Incident
============================================= Dying declaration of (NAME)
given to (INVESTIGATOR) at Angeles Medical Center on
(DATE) at around (TIME) in the presence of (WITNESS) and (WITNESS)
Question 1: Why are you here at Angeles Medical Center?
Answer -> Question 2: Who shot you? Answer -> Question 3: Answer -> Question 4: Answer -> Question 5: Answer -> -End of Dying DeclarationNote: At this juncture (TIME), (NAME) died as pronounced by (DOCTOR)