Schedule 2 Sudden infant death syndrome: particulars

(Clause 6 (c))

1   Particulars

(1)  Full name of mother of deceased infant.

(2)  Usual residential address of mother at time of birth of infant.

(3)  Date of birth of mother.

(4)  Full name of infant.

(5)  Date of birth of infant.

(6)  Name of hospital of birth, or address of place of birth (if not a hospital).

(7)  Sex of infant.

(8)  Usual residential address of infant.

(9)  Address of place at which infant was found deceased or moribund.

(10)  Date of death of infant.