Medico-legal case in OPD: what a private clinic must do Treat first, inform the police in writing, keep an MLC register and refer with the paperwork.

Short answer: if a patient comes to your OPD with an injury, burn, suspected poisoning or a history that suggests a crime or accident, give first aid or treatment first. Then label it a medico-legal case (MLC), inform the police in writing, note the time and the officer's name, and record the injuries and history exactly. If the case is beyond your clinic, stabilise and refer with the MLC number on the slip. No law makes a private doctor wait for the police before treating.

What makes a case medico-legal?

No central Act lists every medico-legal case; the working definition comes from courts and hospital SOPs. The Madhya Pradesh High Court, in an order dated 26 September 2019 (Mala @ Gunmala Lodhi v. State of MP, MCRC No. 8309/2019), described an MLC as "a case of injury or ailment etc., wherein investigation by the legal enforcing agencies is essential to fix the responsibility with regard to cause of injury or ailment." It added that when the attending doctor, after taking history and examining the patient, considers that police investigation is warranted, "such doctor should label such case as Medico Legal Case (MLC)".

The Medico-legal Manual 2025 of AIIMS Rishikesh, a statutory body under the Ministry of Health and Family Welfare, lists these as cases where the treating physician sends police information:

• All injuries: road, industrial and household accidents, animal attacks and falls; suicidal attempts; and assaults, alleged or attempted.
• All burns and scalds, including electrical burns.
• Hanging, strangulation, drowning and choking, in the dead or the survivors.
• Suspected or evident poisoning, snake bite and scorpion sting, intoxication and drug overdose, sexual assault, child abuse, domestic violence and criminal abortion.
• Unconsciousness where the cause is not natural or not apparent, or where no attendant is with the patient.
• Anyone brought dead, anyone brought in suspicious circumstances, and allegations of medical negligence.
• Cases brought by the police or sent by a court.

The SOP adds that "The list of MLC cases is not exhaustive; any case can be labeled as MLC as per discretion of Treating Physician." A case can also become an MLC later in the visit, if further history or examination raises a suspicion of foul play.

Must a private clinic treat an injured patient before the police arrive?

Yes. Pt. Parmanand Katara v. Union of India was decided by the Supreme Court on 28 August 1989 ((1989) 4 SCC 286), after a scooterist hit by a car was sent from the nearest hospital to one about 20 km away that handled medico-legal cases, and died on the way. The Court held:

Every doctor whether at a Government hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life. No law or State action can intervene to avoid/delay the discharge of the paramount obligation cast upon members of the medical profession. The obligation being total, absolute and paramount, laws of procedure whether in statutes or otherwise which would interfere with the discharge of this obligation cannot be sustained and must, therefore, give way.

The Court accepted the Union of India's statement that no provision of the IPC, CrPC or Motor Vehicles Act prevents doctors from attending injured persons before the police arrive, and made operative a 1985 committee decision chaired by the Director-General of Health Services. It says the medical officer should inform the police "and should start the required treatment of the patient", and that "The treatment of the patient would not wait for the arrival of the Police or completing the legal formalities."

The conduct rules point the same way. Regulation 2.1.1 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 says "in case of emergency a physician must treat the patient" and "No physician shall arbitrarily refuse treatment to a patient." Regulation 2.4 says a physician "should, however, respond to any request for his assistance in an emergency." More in our NMC professional conduct guide.

Who decides that a case is an MLC, and does the patient have to agree?

The doctor decides. The Madhya Pradesh High Court said the casualty medical officer or medical officer on duty "only has authority to decide whether the case is to be registered as Medico Legal or not" and that "No other person can induce or pressurise or interfere" in that decision. It said "only verbal communication with the police does not mean registering a Medico Legal Case"; communications "should be written" on the relevant form. It found "no criteria of doing MLC either by a government doctor or by a private doctor", so a private clinic can do it, following the prescribed procedure.

Consent works differently for labelling and for examining. The AIIMS Rishikesh SOP says "No consent of the patient or his relative or accompanying person is required to label a case as MLC." A patient may refuse the medico-legal examination, but "the refusal is for the Medico-legal examination for the purpose of preparing an MLR but not for labeling the said case as an MLC." A refusal "should be documented in the case file and communicated to the Police without fail."

Which BNSS sections apply to a clinic doctor?

The Bharatiya Nagarik Suraksha Sanhita, 2023 (BNSS) repealed the Code of Criminal Procedure, 1973 (section 531). A Press Information Bureau release of 22 July 2026 records that the BNS, BNSS and the Bharatiya Sakshya Adhiniyam "came into force throughout the country with effect from 1 July 2024." Older forms still quote CrPC numbers, so the table gives both; the old numbers are from the BNSS-CrPC correspondence table hosted by the Kerala Prisons department.

Victims of sexual offences and acid attacks: free treatment and police intimation

Section 397 of the BNSS covers "All hospitals, public or private, whether run by the Central Government, the State Government, local bodies or any other person". They must "immediately, provide the first-aid or medical treatment, free of cost" to victims of offences under BNS sections 64 to 68, 70, 71 (rape) and 124(1) (acid attack), or sections 4, 6, 8 or 10 of the POCSO Act, 2012, "and shall immediately inform the police of such incident."

Section 200 of the Bharatiya Nyaya Sanhita, 2023 makes the person "in charge of a hospital, public or private" who contravenes section 397 liable to imprisonment up to one year, or fine, or both. In a single-doctor clinic, that is you; do not charge a fee in these cases.

Section 239 of the BNS separately punishes anyone who, knowing or having reason to believe an offence has been committed, "intentionally omits to give any information respecting that offence which he is legally bound to give", with up to six months, a fine up to ₹5,000, or both.

Road accident cases and the Good Samaritan section

The person who brings an accident victim to your clinic is often a stranger. Section 134A of the Motor Vehicles Act, inserted by the Motor Vehicles (Amendment) Act, 2019 (No. 32 of 2019), says: "A Good Samaritan shall not be liable for any civil or criminal action for any injury to or death of the victim of an accident involving a motor vehicle, where such injury or death resulted from the Good Samaritan's negligence in acting or failing to act while rendering emergency medical or non-medical care or assistance." The explanation defines a Good Samaritan as a person who, "in good faith, voluntarily and without expectation of any reward or compensation renders emergency medical or non-medical care or assistance at the scene of an accident to the victim or transports such victim to the hospital."

Section 134A(2) provides for rules on questioning Good Samaritans. The AIIMS Rishikesh SOP tells its doctors that the Good Samaritan "should be allowed to leave immediately", and disclosure of the Good Samaritan's name and contact details "shall be made voluntary and optional, including in the Medico-Legal Case (MLC) Form provided by hospitals." Take a name and number only if offered.

How do you inform the police from a small clinic?

A clinic in a market lane has no police post in the building. Adapted from the AIIMS Rishikesh SOP, the steps look like this:

1. Start first aid or treatment. Nothing below should delay it.
2. Give the case the next number in your MLC register and mark "MLC" and the number at the top of the OPD slip, by stamp or in red, as the SOP asks.
3. Write a short intimation to your local police station: patient's name, age and sex, alleged place and time of the incident, who brought the patient, and whether the patient is under treatment or referred, with your name and registration number. Keep a copy. If you phone first, send the written note after.
4. Get an acknowledgement with the officer's name, date and time; for OPD cases the SOP says paste it into the OPD register.
5. Record the history in the words of the patient or the person who brought them, marked as "alleged", and record every injury in detail.
6. If the police later ask for a report, date it the day you write it and hand it over against a receipt.

What should a clinic's MLC register contain?

The AIIMS Rishikesh SOP says "All departments are advised to maintain an MLC register at their own level", recording personal particulars, identification marks and particulars of the person accompanying the patient. A bound register with numbered pages, kept separately from the OPD register, works for a small clinic. These columns follow the SOP's documentation points:

When and how should you refer to a government hospital?

Refer after first aid. The 1985 committee decision that the Supreme Court made operative in Parmanand Katara says that "after providing the primary medical aid to the patient, patient can be referred to the hospital if the expertise facilities required for the treatment are not available in that Institution." The Court added that "zonal regulations and classifications cannot also operate as fetters" on the duty to treat. Regulation 2.1.1 of the 2002 conduct regulations allows a physician to refuse treatment and refer when the ailment "is not within the range of experience of the treating physician", but not in an emergency.

Some examinations are meant for a government hospital first. BNSS sections 52 and 184 send the examination of a person accused of rape, and of a rape survivor, to a registered medical practitioner "employed in a hospital run by the Government or by a local authority", and only in that doctor's absence to another practitioner. If a survivor comes to your clinic, section 397 still requires you to give first aid free and inform the police.

When you refer, the AIIMS Rishikesh SOP says "The referring slip must include the MLC number, and the attending doctor is responsible for notifying the Police accordingly." Add your findings, treatment and time of referral, and keep a copy.

What should a clinic doctor not do in an MLC?

• Do not delay first aid or send the patient away to "the MLC hospital", the conduct Parmanand Katara addressed.
• Do not certify beyond your competence. The MP High Court noted that an expert's opinion "must be based within the periphery of his special skill". Whether hurt is "grievous" turns on BNS section 116, which includes fracture or dislocation of a bone or tooth; the AIIMS SOP lets the opinion be reserved until investigations are back. If you cannot tell, say so and refer.
• Do not alter, rewrite or back-date entries. The SOP says reports prepared later from the file "should never be back-dated". Regulation 7.7 of the 2002 regulations makes a practitioner who signs an "untrue, misleading or improper" certificate or report "liable to have his name deleted from the Register." Correct mistakes by a dated, signed addition.
• Do not hand samples or clothes to relatives. The SOP says they "must never be handed over to private individual, attendants or accused"; they go to the investigating officer against a receipt.
• Do not ignore a court summons. The SOP warns that a doctor who does not attend may receive a bailable warrant.

How long should MLC records be kept?

Longer than ordinary OPD papers. The AIIMS Rishikesh SOP says MLC files should be kept confidential "till judgment by the Court of law pertaining to the case has been issued (for practical purposes, there is no time limit)." The 2002 regulations set 3 years for indoor records (1.3.1) and copies within 72 hours of a request (1.3.2). Retention for ordinary records is in our post on how long to keep medical records.

If a patient later files a complaint, the MLC register is part of your defence; see our post on the Consumer Protection Act and medical negligence and our guide to professional indemnity insurance for doctors.