STANDARD RANGE CARDSQD

PLT

COMAGNETIC

NORTH

May be used for all types of direct fire weapons.

DATA SECTIONPOSITION IDENTIFICATION

WEAPON

DATE

REMARKS:

NO. DIRECTION/DEFLECTION ELEVATION RANGE AMMO DESCRIPTION

METERSEACH CIRCLE EQUALS

STANDARD RANGE CARDSQD

PLT

COMAGNETIC

NORTH

May be used for all types of direct fire weapons.

DATA SECTIONPOSITION IDENTIFICATION

WEAPON

DATE

REMARKS:

NO. DIRECTION/DEFLECTION ELEVATION RANGE AMMO DESCRIPTION

METERSEACH CIRCLE EQUALS

ME

DE

VA

CR

EQ

UE

ST

FOR

M

GTA

08-0

1-00

4

LINE

ITEM

EVA

CU

ATI

ON

REQ

UES

TM

ESSA

GE

1Lo

catio

nof

Pic

kup

Site

.

2R

adio

Freq

u.,C

allS

ign,

&S

uffix

.

3N

o.of

Pat

ient

sby

Pre

cede

nce.

4S

peci

alE

quip

men

tReq

uire

d.

5N

umbe

rofP

atie

nts

byTy

pe.

6S

ecur

ityof

Pic

kup

Site

(War

time)

.

6N

umbe

ran

dTy

peof

Wou

nd,

Inju

ry,o

rIll

ness

(Pea

cetim

e).

7M

etho

dof

Mar

king

Pic

kup

Site

.

8P

atie

ntN

atio

nalit

yan

dS

tatu

s.

9N

BC

Con

tam

inat

ion

(War

time)

.

9Te

rrai

nD

escr

iptio

n(P

eace

time)

.

Ref

eren

ce: F

M 8

-10-

6, M

edic

al E

vacu

atio

n in

a T

heat

er o

f Ope

ratio

ns, p

ages

7-7

thro

ugh

7-9.

Reference: FM

8-10-6, Medical Evacuation in a Theater of O

perations, pages 7-7 through 7-9.

LINE

ITEMEXPLA

NA

TION

1.Locationof

PickupSite.

Encryptgridcoordinates.W

henusing

DR

YADN

umeralC

ipher,thesam

eSET

linew

illbeused

toencryptgrid

zoneletters

andcoordinates. To

precludem

isunderstanding,astatem

entism

adethatgrid

zoneletters

areincluded

inthe

message

(unlessunit SO

Pspecifies

itsuse

atalltimes).

2.Radio

Frequency,C

allSign,Suffix.Encryptthe

frequencyofthe

radioatthe

pickupsite,nota

relayfrequency.The

callsign(and

suffixifused)of

personto

becontacted

atthepickup

sitem

aybe

transmitted

inthe

clear.

3.No.ofPatients

byPre cedence.

Reportonly

applicableinfo

&encryptbrevity

codes.A

=U

rgent,B=

Urgent-Surg,C

=Priority,D

=R

outine,E

= Convenience. (If2

ormore

categoriesreported

insam

ere quest,insertthe

word

“break”btwn.each

category.)

4.SpecEquipm

ent.Encryptapplicable

brevitycodes. A

=N

one,B=

Hoist,C

=Extraction

equipment,D

=Ventilator.

5.No.ofPatients

byType.

Reportonly

applicableinform

ationand

encryptbrevitycode.Ifrequesting

MED

EVACforboth

types,insertthew

ord“break”betw

eenthe

litterentryand

ambulatory

entry:L+

#ofPnt-Litter;A

+#

ofPnt-Ambul(sitting).

6.SecurityPickup

Site(W

artime).

N=

No

enemy

troopsin

area, P=

Possiblyenem

ytroops

inarea

(approachw

ithcaution),E=

Enemy

troopsin

area(approach

with

caution),X=

Enemy

troopsin

area(arm

edescor trequir ed).

6.Num

berandty pe

ofWound,Injury,

Illness(Peacetim

e).

Specificinform

ationregarding

patientwounds

bytype

(gunshotorshrapnel). Reportserious

bleeding,alongw

ithpatientbloo d

type,ifknown .

7.Method

of Marking

PickupSite.

Encryptthebrevity

codes.A=

Panels,B=

Pyrotechnicsignal,C

=Sm

okeSignal,D

=N

one,E=

Other.

8.PatientNationality

andStatus.

Num

ber of patients in each category need not be transmitted. Encrypt only applicable brevity

codes. A

= US

military,B

=U

Scivilian,C

=N

on-US

mil,D

=N

on-US

civilian,E=

EPW.

9.NB

CC

ontamination

(Wartim

e).Include

thisline

onlyw

henapplicable. Encryptthe

applicablebrevity

codes.N=

nuclear,B=

biological,C = chem

ical

9.TerrainD

escription(Peacetim

e).Include

detailsofterrain

featuresin

andaround

proposedlanding

site. Ifpossible,describethe

relationshipof

siteto

aprom

inentterrainfeature

(lake,mountain,tow

er).

Line 1.

Line 2.

Line 3.

Line 4.

Line 5.

Line 6.

Line 7.

Line 8.

Line 9.

Date Time Group Discovered.DD

UIC

DETAILS

FREQ

DROPPEDPROJECTEDPLACEDTHROWN

# of UXO

DETAILS

DETAILSAGENTYES

EQUIPMENT FACILITY OTHER

NO

HAZARD AREA

CALL SIGN

8 DIGIT GRID LOCATION

POC PH. #

HH MM MONTH YEAR

Reporting Activity: Unit Identification Code and location (grid of UXO).

Contact Method: Radio Freq / Call Sign, POC, Phone Number.

Type/Number of Ordnance: Dropped, Projected, Placed, or Thrown.Describe Item Details (Without approaching-due to potential tripwire)Size, shape, color, and condition (intact or leaking). Hazard Area.

NBC Contamination: Known or suspected, report type of agent.

Resources Threatened: Report any assets that are threatened.

Impact on Mission. Current tactical situation. Does UXO affect status?

Protective Measures: Measures taken to protect personnel/equipment.

Recommended Priority: Response by EOD technicians or engineers.Stops the unit’s maneuver and mission capability, or threatenscritical assets vital to the mission.Slows the unit’s maneuver and mission capability, or threatencritical assets important to the mission.Reduces the unit’s maneuver and mission capability, or threatensnoncritical assets of value.Has little or no affect on the unit’s capabilities or assets.

IMMEDIATE

INDIRECT

MINOR

NO THREAT

9-line UXO / IED REPORTLine 1.

Line 2.

Line 3.

Line 4.

Line 5.

Line 6.

Line 7.

Line 8.

Line 9.

Date Time Group Discovered.DD

UIC

DETAILS

FREQ

DROPPEDPROJECTEDPLACEDTHROWN

# of UXO

DETAILS

DETAILSAGENTYES

EQUIPMENT FACILITY OTHER

NO

HAZARD AREA

CALL SIGN

8 DIGIT GRID LOCATION

POC PH. #

HH MM MONTH YEAR

Reporting Activity: Unit Identification Code and location (grid of UXO).

Contact Method: Radio Freq / Call Sign, POC, Phone Number.

Type/Number of Ordnance: Dropped, Projected, Placed, or Thrown.Describe Item Details (Without approaching-due to potential tripwire)Size, shape, color, and condition (intact or leaking). Hazard Area.

NBC Contamination: Known or suspected, report type of agent.

Resources Threatened: Report any assets that are threatened.

Impact on Mission. Current tactical situation. Does UXO affect status?

Protective Measures: Measures taken to protect personnel/equipment.

Recommended Priority: Response by EOD technicians or engineers.Stops the unit’s maneuver and mission capability, or threatenscritical assets vital to the mission.Slows the unit’s maneuver and mission capability, or threatencritical assets important to the mission.Reduces the unit’s maneuver and mission capability, or threatensnoncritical assets of value.Has little or no affect on the unit’s capabilities or assets.

IMMEDIATE

INDIRECT

MINOR

NO THREAT

9-line UXO / IED REPORT