Autopsy Report Request

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Ravida Bellencourt
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(( In-game Name )): Ravida Bellencourt

Autopsy Report Request

Post by Ravida Bellencourt »

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Los Santos Emergency Services
AUTOPSY REPORT REQUEST

I. Name of Deceased: FNAME LNAME
II. Date of Death: DD/MM/YYYY
III. Copy request of the following: Check at least ONE (1)
  [ ] Autopsy
  [ ] Narrative Summary
  [ ] Death Certificate
  [ ] Body Diagram
I. Sent to: FNAME LNAME
II. Address: ANSWER
III. Association of Requesting Party: Check ONE (1)
  [ ] Family
  [ ] Beneficiary
  [ ] Los Santos Police Department
  [ ] San Andreas Sheriffs Department
  [ ] Department of Justice

Signature:
FNAME LNAME ((or image))
DD/MM/YYYY
Image
E-Mail the format to the Mortuary Services Command e-mail account below:

Code: Select all

[divbox=white]
[img]https://i.imgur.com/dTpKivz.png[/img]
[divbox=white][right][aligntable=right,0,0,0,0,0,0][img]https://i.imgur.com/tQ8Z5wl.png[/img][/right][/aligntable]

[font=arial][size=180][b]Los Santos Emergency Services[/b][/size]
[hr][/hr]
[size=150][color=red][b]AUTOPSY REPORT REQUEST[/b][/color][/size]

[hr][/hr]
[b]I. Name of Deceased:[/b] FNAME LNAME
[b]II. Date of Death:[/b] DD/MM/YYYY
[b]III. Copy request of the following:[/b][i][size=85] Check at least ONE (1)[/size][/i]
  [ ] Autopsy
  [ ] Narrative Summary
  [ ] Death Certificate
  [ ] Body Diagram
[hr][/hr]
[b]I. Sent to:[/b] FNAME LNAME
[b]II. Address:[/b] ANSWER
[b]III. Association of Requesting Party:[/b][i][size=85] Check ONE (1)[/size][/i]
  [ ] Family
  [ ] Beneficiary
  [ ] Los Santos Police Department
  [ ] San Andreas Sheriffs Department
  [ ] Department of Justice

[hr][/hr]
[b]Signature:[/b]
[i]FNAME LNAME[/i] ((or image))
DD/MM/YYYY
[/divbox]
[img]https://i.imgur.com/dTpKivz.png[/img]
[/divbox]

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