The MLC register: what Indian law actually asks of your casualty

In 1989 a man on a scooter was hit by a car. A passer-by picked him up and took him to the nearest hospital. The hospital would not touch him. It said it was not authorised to handle accident and police cases (MLC) and sent him to another hospital about 20 kilometres away. He died on the way.

That case, Pt. Parmanand Katara v. Union of India, is why every casualty in India now works on one simple rule: treat first, paperwork after. But "paperwork after" still means paperwork. And the MLC register is usually learned from a senior on night duty rather than from a book.

This is a plain guide to what the law actually asks, where it comes from, and where hospitals usually slip.

Start with the reassuring part

The Supreme Court was very clear in Katara. A doctor's duty to save life is, in its words, "total, absolute and paramount", and any procedure that gets in the way of it "must give way". The court even set out the order of things, taken from a 1985 Health Services protocol: tell the duty constable the patient's name, age, sex and the place and time of the incident, start treatment straight away, and send the full report to the police after you have examined and treated the patient.

So nobody expects a casualty medical officer to stop and fill forms while a patient is bleeding. The register is not there to slow treatment down. It is there so that, months or years later, the hospital and the doctor can show exactly what happened.

So when is a case an MLC?

It is the treating doctor's call. The AIIMS Rishikesh MLC manual puts it simply: a case is an MLC when the doctor has reason to believe the police need to look into how it happened. No consent from the patient or the relatives is needed to label a case as an MLC. A patient can refuse the MLC examination, but that is a different thing from refusing the label.

The usual list will look familiar to anyone who has done casualty duty:

• Road accidents, falls from height, industrial and household injuries
• Assault, and injuries that do not match the story you are being told
• Burns, including electrical burns and scalds
• Poisoning, snake bite, drug overdose
• Attempted suicide, hanging, drowning
• Sexual assault, child abuse, domestic violence
• Unconsciousness with no clear natural cause, or with nobody accompanying the patient
• Patients brought dead, and deaths that are sudden or unexplained

The list is not complete, and it does not have to be decided at the door. A case can turn into an MLC on day three of a ward stay, when the real story comes out. When that happens, you register it then, with the real date and time.

Where the duty actually comes from

Here is something that surprises many people: there is no single national law that says "every hospital shall keep an MLC register". The register is how hospitals meet a set of other duties.

The main one is the duty to tell the police. Section 33 of the Bharatiya Nagarik Suraksha Sanhita, 2023, which replaced Section 39 of the old CrPC, asks anyone who knows of certain offences to inform the police "forthwith". Not within a fixed number of hours. Forthwith. Not doing so can be an offence under Sections 211 and 239 of the Bharatiya Nyaya Sanhita, which replaced Sections 176 and 202 of the IPC.

There is a second duty that every private hospital should know about. Section 397 of the BNSS, which replaced CrPC 357C, says all hospitals, public or private, must give first aid or treatment free of cost to victims of rape and acid attack, and to children under the relevant POCSO sections, and must inform the police immediately.

On top of these sit your state's police rules and health department circulars, and the standards of accreditation bodies. Law and order is a state subject, so the exact format and practice can vary. If your state has issued an MLC circular, that is the document to keep at the casualty desk.

What a good register entry looks like

MLC manuals and training material agree on the basics. A register entry, and the MLC report that goes with it, should carry:

• The patient's details and two identification marks
• Who brought the patient, with their name, relationship, address and phone number
• The history, in the patient's or attendant's own words, with the time, place and manner of the incident
• The date and time the examination started
• Each injury described properly: type, site, size, shape and colour
• The police station informed, when, how, and who received it, with the acknowledgement kept in the file
• The examining doctor's name, designation and signature, legible

The AIIMS manual asks for MLC reports to be typed, not handwritten, and to be written "as if you are giving a statement in a court of law". Usually three copies are made: one for the hospital, one for the police and one for the patient on request.

One more rule matters more than it sounds: never back-date. If a case becomes an MLC late, or the police come asking for a report that was never made, write it on the real date and time and say so.

How long should you keep MLC records?

You will hear "ten years" quoted a lot, often with the Medical Council's name attached. We could not find that figure in the Medical Council's regulations. The 2002 ethics regulations, which still apply, ask for indoor patient records to be kept for three years from the start of treatment. Hospital training material adds a sensible rider for MLC records: keep them until the case is closed.

Our practical advice is simple. Keep MLC records at least until the police and court matter is over, never for less than three years, and never destroy anything while a request from the police or a court is still open. If your state or your accreditation body asks for longer, follow that.

Habits that make the register stronger

We found no record of a casualty doctor being prosecuted for an MLC lapse. The usual consequence is a query from the State Medical Council or a call to give evidence, which is exactly when a clear record helps. A few patterns show up in court reports and the press.

The "nil MLC". Some hospitals tell police informally and make no register entry, or make an entry with no report. There is no legal basis for this, and it backfires when the investigating officer later asks for a certificate that the hospital cannot produce.

Reports nobody can read. In 2018 the Allahabad High Court fined three doctors Rs 5,000 each for illegible MLC reports and asked for typed reports in simple words. Years after a case, a clear, typed record is what a doctor relies on when memory has faded.

Sending MLC patients somewhere else. It still happens. In August 2026 the Maharashtra State Human Rights Commission summoned civic health officials over a complaint that some civic hospitals in the state capital were not keeping MLC registers and were sending such patients elsewhere, the Free Press Journal reported on 15 August 2026. Katara was decided 37 years ago.

Informing the police late. The law says "forthwith". Write down when you informed them and who received it.

A short checklist for your casualty

1. Treat first. Tell the duty constable or police station at once, and treat without waiting for them.
2. Let the treating doctor decide what is an MLC. Do not ask the family for permission.
3. Make a register entry for every MLC, with a proper number, the same day.
4. Type the report. Describe each injury in full. Sign it with your name and designation.
5. Record when, how and to whom the police were informed, and keep the acknowledgement.
6. Inform the police again at discharge, referral or death.
7. Never back-date, never overwrite, and keep the records until the case is closed.
8. Keep your state's MLC circular at the desk.

Please note: this article is general information for hospital teams, not legal advice. Rules and formats differ between states. For a specific case, check your state's circular or speak to your hospital's legal adviser.

Sources

• Pt. Parmanand Katara v. Union of India, Supreme Court of India, 28 August 1989, AIR 1989 SC 2039. Judgment text
• AIIMS Rishikesh, Medico-legal manual and SOP, 2025. PDF
• Bharatiya Nagarik Suraksha Sanhita, 2023, Section 33 and Section 397. Section 33, Section 397
• Government of Kerala, Department of Prisons, BNS to IPC and BNSS to CrPC comparison tables. BNS, BNSS
• Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, clause 1.3.1. NMC PDF