LINE 1 -- DATE AND TIME______________________________(DTG)
LINE 2 -- UNIT________________________________________(Unit Making Report)
LINE 3 -- INCIDENT ___________________________________(DTG of Incident)
LINE 4 -- LOCATION___________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator) of Emergency)
LINE 5 -- EMERGENCY_________________________________(Specified Medical Emergency)
LINE 6 -- UNIT AFFECTED______________________________(Affected Friendly Unit)
LINE 7 -- NARRATIVE__________________________________(Free Text for Additional Information Required for Clarification of Report)
LINE 8 -- AUTHENTICATION____________________________(Report Authentication)