HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM
RELlC INVENTORY REGISTRATION FORM
Form Code: HSW-F01
Department: ________________________________
Date: ____ / ____ / ______
1. BASIC INFORMATION
1.1 Relic ID Code: _______________________________________
1.2 Relic Name / Title: __________________________________
1.3 Relic Type (tooth / bone / hair / object / other):
_______________________________________
1.4 Tradition / Period / Approx. Date:
_______________________________________
1.5 Origin / Provenance (country, place, temple, etc.):
_______________________________________
_______________________________________
2. DESCRIPTION
2.1 Short Physical Description (size, material, colour):
_______________________________________
_______________________________________
2.2 Religious / Historical Significance (if known):
_______________________________________
_______________________________________
3. SOURCE DETAILS
3.1 Date Received: ____ / ____ / ______
3.2 Received From (name and role):
_______________________________________
3.3 Address / Contact:
_______________________________________
_______________________________________
4. INTERNAL REGISTRATION
4.1 Receiving Officer (name): ____________________________
4.2 Signature: _____________________ Date: ____/____/____
4.3 Checked / Approved By: _______________________________
4.4 Signature: _____________________ Date: ____/____/____
5. ATTACHED DOCUMENTS (tick all that apply)
[ ] Donation letter
[ ] Provenance statement
[ ] Photographs
[ ] Testing report
[ ] Other: _____________________________
Office Use Only:
Record entered into inventory system by:
Name: __________________________ Date: ____/____/____
