كلاسه پرونده:.......................... |
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نام و نام خانوادگي خواهان: ....................شغل.....................دين...................تابعيت.................تاريخ تولد.............. |
نشاني:.........................................................................................................................وكيل: دارد□ ندارد□ |
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نام و نام خانوادگي خوانده: ....................شغل.....................دين...................تابعيت.................تاريخ تولد............... |
نشاني:.........................................................................................................................وكيل: دارد□ ندارد□ |
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نوع اتهام: ...................................................................................................................................................................................... |
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متهم در بازداشت به سر مي‌برد؟ بلي□ خير□ |
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نوع قرار: ....................................................................................................................................................................................... |
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خلاصه كيفر خواست: .............................................................................................................................................................. |
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تصميم جلسه اول: .................................................................................................................................................................... |
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تصميم جلسه دوم: ................................................................................................................................................................... |
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تصميم جلسه سوم: .................................................................................................................................................................. |
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راي دادگاه: .................................................................................................................................................................................. |
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آيا به راي صادره اعتراض شده است؟ بلي□ خير□ |
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تنظيم كننده: ...................................................... |
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فرم شماره 2164/2201/24 دفتر تشكيلات و برنامه‌ريزي |
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