HICS254 - DISASTER VICTIM / PATIENT TRACKING
HICS - Hospital Incident Command System
1. Incident Name
Page
Of
Express Sender
{var MsgSender}
2. Operational Period (#):
Date From
To
Time From
To
3. Area (Triage or Specific Treatment Area)
Field Tag Number
Medical Record #
Name
Sex
DOB - Age
Triage Category
Location of Procedures
Procedure Time
Disposition
Disposition Time
4.
Prepared By
:
Date
Time:
Facility:
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