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Page 1: ACTAR.org · 1 D Not Applicable Not Trapped Date of Birth On Duty Accident everity TUPPED/ EXTRICATED On Duty ... PCP Other Drug Medication Type Unknown First Phone Number O None

Page 2: ACTAR.org · 1 D Not Applicable Not Trapped Date of Birth On Duty Accident everity TUPPED/ EXTRICATED On Duty ... PCP Other Drug Medication Type Unknown First Phone Number O None

Page 3: ACTAR.org · 1 D Not Applicable Not Trapped Date of Birth On Duty Accident everity TUPPED/ EXTRICATED On Duty ... PCP Other Drug Medication Type Unknown First Phone Number O None

Page 4: ACTAR.org · 1 D Not Applicable Not Trapped Date of Birth On Duty Accident everity TUPPED/ EXTRICATED On Duty ... PCP Other Drug Medication Type Unknown First Phone Number O None

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