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Information About Injury

No.
Question
Options
1
How did the Incident happen?
Please fill your answer here
2
Did any First-Aid from the vehicle use?
Yes
No
N/A
3
What are the Properties damaged due to the accident?
None
Vehicle
Equipment
Private Property
Person
4
What is the Severity of the damage for Vehicle?
None
Minor
Serious
Major
5
What is the Registration number of the damaged vehicle?
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6
What is the Severity of the damage for Equipment?
None
Minor
Serious
Major
7
Name the Equipment damaged in the accident?
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8
What is the Severity of the damage for Private Property?
None
Minor
Serious
Major
9
What is the Severity of the damage for the Person?
None
Minor
Serious
Major
Fatal
10
The number of people injured in the accident?
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11
What is the Estimated Cost of Damage?
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12
What were the Environmental Conditions at the time of the incident?
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13
What was the Road Condition at the time of the incident?
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14
What are the Actions taken by the Police Department?
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15
Did the Tow-truck arrive at the incident spot?
Yes
No
N/A
16
What are the Actions taken by the Ambulance?
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