HICS-203

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ka1vgm
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HICS-203

Post by ka1vgm » Fri Mar 09, 2018 11:59 am

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          <p class="P5">HICS 203 – ORGANIZATION ASSIGNMENT LIST</p>
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          <p class="P12">&nbsp;</p>
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          <p class="P11">1. &nbsp;INCIDENT NAME</p>
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          <p class="P11">2. &nbsp; DATE PREPARED</p>
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          <p class="P13"><span class="T2">4. &nbsp;OPERATIONAL PERIOD DATE/TIME</span></p>
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          <p class="P6">POSITION</p>
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          <p class="P7"><span class="T2">NAME / AGENCY</span></p>
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          <p class="P14">Medical/Technical Specialist (Type)</p>
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          <p class="P9">6. &nbsp;Operations Section</p>
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          <p class="P14">Business Continuity Branch</p>
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          <p class="P14">Resources Unit</p>
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      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">8. &nbsp;Logistics Section</p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Chief</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="8a" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Service Branch</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="8b" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Support Branch</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="8c" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Other Branch:</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="8d" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">9. &nbsp;Finance/Administration Section</p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Chief</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9a" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Time Unit</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9b" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Procurement Unit</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9c" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Compensation/Claims Unit</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9d" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Cost Unit</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9e" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P14">Other Branch:</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"><input type="text" name="9f" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">10. &nbsp;Agency Representative (in Hospital Command Center)</p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P15">Agency</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P16"><input type="text" name="10a" class="in2" size="65" value=""> <br /></p>
          <p class="P16"><input type="text" name="10b" class="in2" size="65" value=""> <br /></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P16">&nbsp;</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1"> </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P16">&nbsp;</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10"></p>
        </td>
      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">11. &nbsp;Hospital Representative (in External EOC)</p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P15">External Location</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P16"><input type="text" name="11a" class="in2" size="65" value=""></p>
          <p class="P16"><input type="text" name="11b" class="in2" size="65" value=""></p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P16">&nbsp;</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10">&nbsp;</p>
        </td>
      </tr>
      <tr class="Table13">
        <td style="text-align: left; width: 2.7167in;" class="Table1_A2">
          <p class="P16">&nbsp;</p>
        </td>
        <td colspan="3" style="text-align: left; width: 1.4833in;" class="Table1_C1">
          <p class="P10">&nbsp;</p>
        </td>
      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">12. PREPARED BY (RESOURCES UNIT LEADER) <input type="text" name="12" class="in1" size="55" value=""><br /></p>
        </td>
      </tr>
      <tr class="Table13">
        <td colspan="4" style="text-align: left; width: 2.7167in;" class="Table1_C1">
          <p class="P9">13. FACILITY NAME <input type="text" name="10c" class="in1" size="65" value=""><br /></p>
        </td>
      </tr>
    </tbody>
  </table>
  <p class="P8">&nbsp;</p>
</form>
</body>

</html>
[/code]

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