COUNT 4 That you OKO VICTORIA INAKU (f) on the 29th of October, 2014 or thereabout, at the Maitama District Hospital, Abuja, made a false document to wit: Chemical Pathology Laboratory Report Form in the name of one Aniukwu Richard Chinonso with Hospital No. 444068, knowing same to be forged and intending that the same shall be dishonestly used as genuine to support a visa application to enable Aniukwu Richard Chinonso (now at large) to travel to India for medical treatment and you thereby committed an offence contrary to section 363 and punishable under section 364 of the Penal Code CAP 532 Laws of the Federal Capital Territory, Abuja 2006. 11