Absondee Form

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ABSCONDEE FORM

Client Name …………………………………………………………………………………….


Dare report is prepared …………………………….. Report prepared by…………………..
Date of absconding ……………………………… Time of absconding ……………………..
Client’s Height………………………………
Skin color ………………………………….
Mode of dressing at the time of absconding…………………………………………………….
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Mental Status at the time of Absconding
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Immediate Family Member Name Phone Number
…………………………………………… …………………………………………….
…………………………………………… ……………………………………………...
……………………………………………. ………………………………………………

Staff on Duty at the time of Absconding ……………………………………………………….


Designation………………………………………………………………………………………..
Police Station the Report is filed …………………………………………………………………
NB:
A copy of this report to be stamped at the police station and returned in the client’s file
PHONE: +254774514635

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