3. The report made following a psychiatric examination must be signed by the examining physician. He must, in particular, state in the report
(1) that he himself has examined the person;
(2) the date of the examination;
(3) his diagnosis, even if only provisional, concerning the mental state of the person;
(4) in addition to what is provided in article 29 of the Civil Code, his opinion as to the gravity and probable consequences of the person’s mental state;
(5) the reasons and facts upon which his opinion and diagnosis are based and, among the facts mentioned, those which he himself has observed and those which have been communicated to him by others.