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| | WORK PHONE: | INJURY: | DISPOSITION: | | :--- | :--- | :--- | :--- | | (212) 555-1245 | N/A | Bruised left eye, laceration to lower lip (swelling noted) | Treated on scene by EMS (FDNY). Refused transport to hospital. | uf49 format nypd template top

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Always keep a copy for your own records, noting when you submitted it. Why the Correct Format Matters uf49 format nypd template top