1st Call Sheet (Fill Out Completely)
Deceased Name ____________________________________________________________________________
Informant/Person Calling: ____________________________________________________________________
Relationship: ________________________________ Phone Number: ______________________________
Released: Yes No By Whom:___________________________________
Date & Time of Call: __________________________
Prearranged: Yes No Maybe
Received by: _________________________________
Loc. Desired:_________________________________
Next of Kin/Contact: ________________________________________________________________________
Relationship: ________________________________ Phone Number(s): ____________________________
Location of Deceased/Address/Facility (INCLUDE ZIPCODE):
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Morgue Room #: ___________________ Time of Death: __________am/pm
Date of Birth: _______________ Date of Death: ______________
Veteran: Yes No Weight ___________
Family Present During Removal: Yes No PTE: Yes No
Cremation: Direct Other P & E Pick-Up Only Embalming Fa
Notes:_____________________________________________________________________________________
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Nurse/Family Sign: _________________________________________________________________________
Removal Personnel: _________________________________________________________________________
Funeral Home Requesting Removal/Transport:____________________________________________________