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Annex 2. Missing Persons Form
Missing Person Number/Code: (Use unique numbering and include it on associated files, photographs or stored objects.) |
Interviewer name: |
Interviewer contact details: |
Interviewee(s) name(s): |
Relationship with missing person: |
Contact details Address:____________________________________________________________________________ Telephone:__________________________________ E-mail:___________________________________ |
Contact person for missing person, if different from above: (who to contact in case of news: name/contact details) |
MP N°./Code: ____________________________________________ Missing Persons Data
A. PERSONAL DETAILS
A.1 |
Missing person’s name |
Include surname, father’s and/or mother name, nicknames, aliases: |
A.2 |
Address/Place of residence |
Last address & usual address if different from the former: |
A.3 |
Marital status |
Single |
Married |
Divorced |
Widowed |
Partnership |
A.4 |
Sex |
Male |
Female |
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A.5 |
If female |
Unmarried name: |
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Pregnant |
Children |
How many? |
A.6 |
Age |
Date of birth: |
Age: |
A.7 |
Place of birth, nationality, principal language |
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A.8 |
Identity document(Main details, N°, etc.) |
If available, enclose photocopy of ID |
A.9 |
Fingerprints available? |
Yes |
No |
Where: |
A.10 |
Occupation |
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A.11 |
Religion |
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B. EVENT
B.1 |
Circumstances leading to disappearance:(use additional sheet if necessary) |
Missing Person alive (incl. name and address): |
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Has this case been registered/denounced elsewhere? |
Yes |
No |
With whom/Where: |
B.2 |
Are other family members missing, and if so, have they been registered/identified? |
List name, relationship, status: |
MP N°/Code:
Missing Persons Data
C. PHYSICAL DESCRIPTION
C.1 |
General description (indicate exact measure, or approximate AND circle the corresponding group) |
Height (exact/estimated?): |
Short |
Average |
Tall |
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Weight: |
Slim |
Average |
Fat |
C.2 |
Ethnic group/Skin color |
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C.3 |
Eye color |
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C.4 |
a) Head hair |
Color: |
Length: |
Shape: |
Baldness: |
Other: |
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b) Facial hair |
None |
Moustache |
Beard |
Color: |
Length: |
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c) Body hair |
Describe |
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C.5 |
Distinguishing features Physical e.g. shape of ears, eyebrows, nose, chin, hands, feet, nails; deformities |
Continue on additional sheets if needed. Use drawings and/or mark the main findings on the body chart. |
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Skin marks scars, tattoos, piercings, birth-marks, moles, circumcision, etc. |
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Past injuries/amputations include location, side, fractured bone, joint (e.g., knee), and if person limped |
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Other major medical conditions operations, diseases, etc. |
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Implants pacemaker, artificial hip, IUD, metal plates or screws from operation, prosthesis, etc. |
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Types of medications used at time of disappearance |

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C.6 |
Dental condition
Please describe general characteristic, especially taking into account the following:
• Missing teeth
• Broken teeth
• Decayed teeth
• Discolorations, such as stains from disease, smoking or other
• Gaps between teeth
• Crowded or crooked (overlapping) teeth
• Jaw inflammation (abscess)
• adornments (inlays, filed teeth etc)
• any other special feature
Dental treatment
Has the Missing Person received any dental treatment such as
• Crowns, such as gold capped teeth
• Color: gold, silver, white
• Fillings (incl. color if known)
• False teeth (dentures) upper, lower
• Bridge or other special dental treatment
• Extraction
Also indicate wherever there is uncertainty (for example, the family member may know that an upper left front tooth is missing, but is unsure which one).
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If possible, use a drawing, and/or indicate the described features in the chart below
If the missing person is a child, please indicate which baby teeth have erupted, which have fallen out and which permanent teeth have erupted and use the chart below
 BABY/PRIMARY TEETH
 ADULT/PERMANENT TEETH
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MP N°/Code:_______________________________________Missing Persons Data
D. PERSONAL EFFECTS
D.1 |
Clothing (worn when last seen/at time of disaster) |
Type of clothes, colors, fabrics, brand names, repairs: describe in as much detail as possible. |
D.2 |
Footwear (worn when last seen/at time of disaster) |
Type (boot, shoes, sandals), color, brand, size: describe in as much detail as possible. |
D.3 |
Eyewear |
Glasses (color, shape), contact lenses: describe in as much detail as possible. |
D.4 |
Personal items |
Watch, jewelry, wallet, keys, photographs, mobile phone (incl. number), medication, cigarettes, etc: describe in as much detail as possible. |
D.5 |
Identity documents (which the person was/might have been carrying when last seen/at time of disaster) |
Identity card, driving license, credit card, video club card, etc. Take photocopy if possible. Describe the information contained. |
D.6 |
Habits |
Smoker (cigarettes, cigars, pipes), chewing tobacco, betel nut, alcohol, etc. Please describe, incl. quantity. |
D.7 |
Doctors, medical records, X-rays |
Give details of doctor, dentist, optometrist, or other. |
D.8 |
Photographs of missing person |
If available, enclose photos or copies of photos as recent and clear as possible, (with teeth visible). Also, photos of clothing worn when disappeared. |
Note: The information collected in this form will be used for the search and identification of the missing person. Its content is confidential and any use outside of the intended context will need explicit consent by the interviewee.
Place and date of interview:______________________________________________________________
Interviewer signature: ________________________Interviewee signature: ________________________
If requested, a copy of this form with contact details of interviewer should be made available to the interviewee.
Note: Those interested in adapting or copying this form, please download it, in MS Word or PDF format, at www.paho.org/disasters (click on Publications Catalog, and see the special page about Dead Bodies in Disaster Situations).
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