miaasndeds¢ ecordmeSri@© / Department of Anatomy 9e5es 823 | Faculty of Medicine Secon geaiinc acm ecendmebaiged 9268599 / Application Form Carctd mas S8aneo acsimed me Donors Name . 28x00 .... Donors Address HM © qoOa Donors ID No. ba . Age 38 Soe mda 38 oye sex Female / Male qag8oe mrdgal tne .... Date of submission of application @es Dde0md mdina 5 gtim® d B8a¢ Scans Details of any surgical treatment undertaken mdomced me ... Name of next of kin handing ‘over ‘the body .. mdnded @8mc ..... : Address of next of kin handing © over the body. mrdacyed th m © aa ID No of next of kin .... sdcreceBa ScloSemced eso¢s ded maor0bede ecordneSaiqod eed Odetear og em edoa O80ma S30 | do here by certify that | am willing to donate my body after death to the Department of Anatomy Faculty of Medicine, University of Peradeniya. 2 @ G20 edoe endgsl oO 68 aBEd65 GBHa ecordasssIQd UQS 504, BaBo Qoeed SSe SBE EMDE G20 oe HIS OS® BE END. qUBOD HOSA al coe Bae 8o,dovbad smeo.8a ota qamdan emsd. Once the body is handed over it becomes the property of the department. Please read the attached information sheet regarding the embalming procedure. If the body is not embalmed as instructed, it will not be accepted. Please note that registration in the department is not an essential requirement for donating bodies.