| Date | 11/21/2024 |
|---|---|
| Report Categories |
|
| Date Of Incident | 11/21/2024 |
| Any Injury | Head Injury |
| Upload Image/Video/Document |  |
| Worker Department | Fire |
| Worker Phone Number | 78945612330 |
| Worker Name | Ryan Tom |
| Worker Address | Des plaines United States Map It |
| State / Province | illinois |
| City | Desplaines |
| ZIP / Postal Code | 60016 |
| Service Amount | Service Amount, Qty: 1, Price: $ 30.00 |
| Total | $30.00 |
| Credit Card | Visa XXXXXXXXXXXX4242 |
