(此处印制公安机关名称)

　　现场勘验笔录

　　勘验时间_____年_____月_____日_____时_____分_____至_____年_____月_____日_____时_____分

　　勘验地点____________________________________________________________________________

　　勘验人员姓名、单位、职务(职称)____________________________________________________

　　____________________________________________________________________________________

　　____________________________________________________________________________________

　　勘验过程及结果_______________________________________________________________________

　　____________________________________________________________________________________

　　____________________________________________________________________________________

　　____________________________________________________________________________________

　　____________________________________________________________________________________

　　____________________________________________________________________________________

　　现场勘验人员：__________　记录人：__________

　　当事人或者见证人(签名 )： _______________