Narcotics Check Off Narcotics Check Off Narcotics Check Off Oncoming Medic / Paramedic #1 * Patient Care Provider (First and Last Name REQUIRED!!!) Driver/Operator Name * Driver/Operator Name Shift Location * Beaumont Baytown San Antonio The Woodlands Cypress/Katy Houston Corpus Christi Clear Lake/ Webster Kingwood Dallas Stephenville Kingwood Longview College Station Round Rock New Braunfels Unit Number * M-101 M-102 M-103 M-104 M-105 M-106 M-107 M-108 M-109 M-110 M-111 M-112 M-113 M-114 M-115 M-116 M-117 M-118 M-119 New Option Vehicle Number * M-101 M-102 M-103 M-104 M-105 M-106 M-107 M-108 M-109 M-110 M-111 M-112 M-113 M-114 M-115 M-116 M-117 M-118 M-119 Time Date Versed (Count) * Please insert the Versed count here. Versed is only to be stored in the narcotics lock box. Relieved Medic / Paramedic #2 * Who was the previous Paramedic on shift? Please Type their First and Last Name Above Signature * Clear Please sign using a stylus or finger on any touch screen device. reCAPTCHA If you are human, leave this field blank.
