CASUALTY REPORT FORM

Contact SDG ACS Staff on this forms use.


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  CASUALTY REPORT FORM
San Diego County ARES - ACS

     Incident or Event Location    

Report Time    Date    Verified By         
Tracking #      Destination Hospital    
Extent of Injury       Describe      
Ambulance  
Additonal Comments on this Casualty if Any
{var CasComm1}

Tracking #     Destination Hospital  
Extent of Injury      Describe    
Ambulance   
Additonal Comments on this Casualty if Any
{var CasComm2}
Tracking #     Destination Hospital  
Extent of Injury      Describe  
Ambulance    
Additional Comments on this Casualty if Any
{var CasComm3}


   Senders comments if any

   {var SendComm}

 Vers 13.3