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MOHAWK VALLEY AMBULANCE CORPS
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Supply and Equipment Issue
Name
(Required)
Date:
(Required)
What does this involve?
(Required)
Expired Medication
Expired Soft Goods
Medical Supply
Monitors
Bags
Stretcher
Stair Chair
Vending Machine
Radio
Ventilator
IV Pumps
Other
What rig is the supplies and equipment issue in?
(Required)
Select Rig
Describe the issue:
(Required)
Submit Supply/Equipment Issue Report
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