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Property Room Submission Form
Property Room Submission
Employee Name submitting items into SBC property room
Patient First Name
Patient Last Name
Patient DOB
Hospital Exam was Completed At:
Item #1 being submitted:
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Item #2 being submitted:
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Item #3 being submitted:
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Item #3 being submitted:
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Comments to administration about submission items
I confirm thatlaw enforcement has been notified that all materials I am submitting into the SBC property room must be picked up from our office within 7 days.
Yes, I Confirm
Date of Submission
Time of Submission
I confirm I am using the above date and time to complete the evidence kit chain of custody as the "RECEIVED BY" and the "RECEIVED BY" agency is SBC Property room
Yes, I Confirm
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