Employee Details
Location
Patient Details
Male
Female
Other
Incident Details
Incident Type
Abrasion/Laceration
Blister
Bite/Sting
Soft Tissue Injury
Faint/Near Faint
General Medical
Headache
Nausea/Vomitting
Burn
Alcohol/Drug Intoxication
Query Fracture
Head Injury/Concussion
Epistaxis
Breathing Problems
Abdominal Pain
Environmental Exposure
Other
Alcohol Involvement
Present
Not Present
Patient Care Report
Yes
No
Ambulance Activation
Yes
No
Critical Incident
Yes
No
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