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Incident Number: V2000360 Patient Name: Mercado, Miguel <br />Incident Date/Time: 01/20/2020 23:26:10 <br />Disp. Notified: 01/20/2020 <br />23:26:08 <br />Unit Disp.: 01/20/2020 <br />Unit#: VE32/VE32 <br />Beginning O <br />23:26:10 <br />Enroute: 01/20/2020 <br />23:28:37 <br />On Scene: 01/20/2020 <br />23:32:35 <br />Patient Contact: 01/20/2020 <br />23:38:09 <br />Depart Scene: 01/21/2020 Base Hospital 01/21/2020 <br />00:06:53 Contact: 23:47:09 <br />At Destination: 01/21/2020 <br />00:14:25 <br />TransferofCare 01/21/2020 <br />at Destination: 00:15:20 <br />In Service: 01/21/2020 <br />00:21:24 <br />Turn-Around <br />Delay: <br />Odom: <br />Ending Odom: O <br />Unit Personnel <br />Crew Member Level of Certification <br />.,..,,,.., ...... ___________ ~---------------------------·-·· <br />Gilbert, Tylor (P32750) Paramedic <br />Dale, Ryan (P38789) Paramedic <br />Crew Member Gilbert, Tylor (P32750) <br />Completing this <br />Report: <br />Rad io Medic <br />Primary Patient Caregiver <br />Billing Information <br />EMS Agency Name: Fountain Valley Fire Department <br />PCR #: ca2a4d0a46f1453f81898d0d 1 ccf <br />eb65 <br />EMS Subscription <br />Membership#: <br />Work Related?: No <br />Transporting Agency: Care :Ambulance service <br />(1639131436) <br />Printed: 01/22/2020 08:55 <br />Page 9 of9