Labels:text | screenshot | software | multimedia software OCR: NEW YORK CITY PUBLIC SCHOOLS - DIVISION OF SCHOOL FACILITIES B-11 QUEENS PLAZA NORTH. LONG ISLAND CITY, NEW YORK - 11101 INCIDENT/PROPERTY LOSS REPORT DSF OFFICE/DEPARTMENT SUPERVISOR PHONE NUMBER DATE 1 DATE OF INCIDENT TIME OF INCIDENT a.m. p.m. -20-0 2- 2 >-01-2 DESCRIPTION OF INCIDENT: NOTE: STATEMENTS OF VICTIM(S) AND/OR WITNESS(ES) SHOULD BE ATTACHED 2 NUMBER OF VICTIM(S) NOTE: PLEASE RECORD INFORMATION 3 NUMBER OF F MORE THAN ONE WINES ON A SEPARATE PAGE AND ATTACH. WITNESS(ES) PLEASE RECORD INFORMARON SEPARATE PAGE AND ATTACH V LAST NAME FIRST NAME W LAST NAME FIRST NAME ADDRESS BOROUGH P CODE APLA BOROUGH ZIP CODE APT M TELEPHONE ( ) NOTIFICATION (Name) TELEPHONE ( ) STAFF (THO) OTHER Odermy) STAFF (TIS0) ODHIER Odentity) EXTENT OF INJURIES: NONE TREATED AT SCENE PERSONAL PHYSICIAN REFUSED MED. TREAT. EMER. RM. TREAL. HOSPITALIZED 4 PROPERTY LOSS: BOE EMPLOYEE NUMBER OF ITEM(S) NUMBER AND PROVIDE BRAND NOVE MORELLET TRIAL NUMBER A & NUM MILLE FOIE EACH TEM. ER AND L DESCRIPTION OF ITEM(S): O $ S PROPERTY REPLACEMENT REQUIRED FOR BOE BUSINESS YES NO SUPERVISOR: SECURITY OFFICE USE ONLY 5 COMPLAINT BY VICIM OTHER 6 CASE DATE D LAST NAME FIRST NAME REFERRED TO: PRECINCT NUMBER COMPLAINT NUMBER DISPOSITION: ARREST BY POUCE BY T LAST NAME FIRST NAME SHIELD NUMBER SUPERVISOR: ARREST NUMBER PRINT NAME: ASSAULT ROWERY CONTROLLED SUBST. MENACING .... HARASSMENT SEX OFFENSE BOMB THREAT HOMICIDE RECKLESS ENDANGERMENT LARCENY WEAPONS POSS DEMONSTRATION VANDAUSM OTHER Opacity? DISORDERLY CONDUCT GANG RIGHT SUSPICIOUS FIRE KIDNAP CUF PORM
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