FORM 15
[Rule 17 (1)(i)]
CASE SUMMARY MAINTAINED BY THE CHILD WELFARE COMMITTEE
Case No…………………………... In Re……………………………..Case Record……………………..
1. Name of the child……………………………………………………..
2. Father’s/Mother’s/Guardian’s name (if available)………………….
3. Date of production of the child………………………………………
4. Name of person producing the child………………………………
5. A list of all follow up dates (of the child, before the Committee)………………...
6. Orders passed by the CWC (tick as applicable)
(i) Declaration that child is in need of care and protection.
(ii) Finding on age of child
(iii) Medical Examination
(iv) Interim custody
(v) Undertaking (by parent, guardian or fit person, if applicable)
(vi) Order appointing Case Worker & NGO etc.
(vii) Order for compensation/recovery of wages (if applicable)
(viii) Transfer order
(ix) Final Order (concluding inquiry)
(x) Any other order.
7. Medical Records including but not limited to age verification………………….
8. Social Investigation Report under Form 22………………………………………
9. Individual Care Plan under Form 7……………………………………………..
10. Rehabilitation Card in Form 14……………………………………………………
11. Case History Form 43………………………………………………………………
12. All details, documents and records with regards to Sponsorship/Foster Care/Adoption services (ifapplicable).
Date:
Place:
(Signatures)
Child Welfare Committee