Difference between revisions of "Example Paperwork"
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[br] | [br] | ||
REVIEWER COMMENT: [field][br] | REVIEWER COMMENT: [field][br] | ||
|} | |||
{| class="mw-collapsible mw-collapsed wikitable" | |||
! Internal Affairs: Agent Report - Unattributed | |||
|- | |||
|[center][b][i]Internal Affairs Report[/b][/i][br] | |||
Agent: [field][br] | |||
Subject in Question: [field][br] | |||
[i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center][br] | |||
[hr][br] | |||
[b]Incident: [/b][field][br] | |||
[b]Location(s): [/b][field][br] | |||
[b]Personnel involved in Incident: [/b][field][br] | |||
[hr] | |||
[b]Narrative: [/b][br] | |||
[field][br] | |||
[hr] | |||
[b]Agent Signature: [/b][field][br] | |||
[hr] | |||
[b]Notes: [/b][field][br] | |||
Stamp below with the Magistrate's stamp: | |||
|} | |||
{| class="mw-collapsible mw-collapsed wikitable" | |||
! Internal Affairs: Complaint - Fox McCloud | |||
|- | |||
|[large][b][center]NANOTRASEN STATION CYBERIAD[/b][/center][/large] | |||
[i][center]INTERNAL INVESTIGATION REPORT[/i][/center][hr] | |||
Type of Complaint: [field] | |||
Complainant: [field] | |||
Time of occurrence: [field] | |||
Location of occurrence: [field] | |||
Employee(s) involved: [field] | |||
Details of Complaint: [field][hr] | |||
How received: [field] | |||
Complaint investigated by: [field] | |||
Reviewed by: [field] | |||
Reviewer Comment: [field] | |||
Signature: [field] | |||
|} | |} |
Revision as of 17:04, 17 June 2017
General Paperwork
Marriage Certificate - SigholtStarsong |
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[center][logo]
[small]Nanotrasen Form CU-513(b)[/small] [i][large]Certificate of Marriage[/large] [hr] This is to Certify On this day, the [field] of [field], in the year [field], [field] and [field] Were United In Matrimony Aboard the Nanotrasen Science Station Cyberiad[/small] [hr] [/center] [field] [small]Minister [field] [small]Witness[/small] [field] [small]Witness[/small] |
Pod Sale Receipt - LightFire53 |
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[center][logo]
[large]NSS Cyberiad[/large] Space Pod Sale reciept[/center] Name of Manufacturer: [field] Name of Purchaser: [field] Product of Sale: [field] Additional Features or Items: [field] Price: [field] Manufacturer's signature: [field] Customer's Signature: [field] |
Item Request Form - MagmaRam |
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[b]ITEM REQUEST FORM[/b][br]
[br] [b]APPLICANT NAME:[/b][field][br] [b]REQUESTED ITEM:[/b][field][br] [b]REASON FOR REQUEST:[/b][field][br] [b]APPLICANT SIGNATURE:[/b][field][br] [b]SIGNATURE OF RELEVANT HEAD OF STAFF:[/b][field][br] [b]SIGNATURE OF HEAD OF PERSONNEL:[/b][field][br] [b]DATE AND TIME:[/b] |
Cargo General Request Form - Artorp |
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[center][large]General Request Form[/large][/center]
[list] [*]Name: [small][field][/small][br] [*]Rank: [small][field][/small][br] [*]Request: [small][field][/small][br] [*]Reason for request: [small][field][/small][br] [/list] [i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center][br] [u]Sign Below and include any relevant stamps.[/u][br] [hr] |
Security Paperwork
Search Warrant - SigholtStarsong |
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[small]Form NT 761-8[/small]
[center][logo] [large]Search Warrant[/large] [hr] Issued: [field] Case Number: [field] [small]In the Matter of the search of: [field] TO: Any Authorized Officer of Nanotrasen Affidavit(s) having be made before me by [field] whom has reason to believe that on the persons or premises inscribed above there is extant evidence thereupon or within, specifically: [field] and other property that constitutes evidence of a criminal offense, contraband, fruits of crime or items otherwise criminally possessed or property designed or intended for use or which is or has been used as means of committing a criminal offense, specifically the conspiracy to commit, or the commission of knowing presenting a false and fictitious claim upon or against Nanotrasen or its' subsidiaries in violation of SolGov Title 319, General penal code sections 7, 28, 72, and Title 601, General Penal Code sections 13 and 22 (incorporating 88 IFR 1092.26 and 27). I am satisfied that the affidavit(s) and any recorded testimony establish probable cause to believe that the property so described is now concealed on the premises, person, or property above-described and establish lawful grounds for the issuance of this warrant. YOU ARE HEREBY COMMANDED to search the premises, property or person above within [field] minutes of the date of this warrant's issuance for the concealed property specified, and if the property is found to seize same, leaving a copy of this Warrant as a receipt for the property taken as required by Nanotrasen regulation.[/small] Witness (Rank): [small]Given under the Seal of the High Court of Nanotrasen.[/small] By [field] [hr] |
Arrest Warrant - SigholtStarsong |
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[center][logo]
Nanotrasen Station Cyberiad Security Department [hr] [large][b]Arrest Warrant No.[field][/b][/large] [hr] Security forces are hereby authorized and directed to detain [field], AKA [field]. They will disregard any claims of immunity or privilege by the Suspect or agents acting on the Suspect's behalf. Security forces will bring [field] forthwith to the Brig to serve their sentence for the following crimes: [field] The Suspect will be expected to serve a sentence of [field] for the aforementioned crimes. Glory to Nanotrasen. Issuing Authority: [field] [small]Please stamp below the line to affirm the issuance of this warrant.[/small] [hr] |
Witness Deposition - SigholtStarsong |
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[center][logo]
[large][b]Offical Testimonial Deposition[/b][/large] [hr] Witness: [field] Officer receiving deposition: [sign] [hr] Testimony: [field] [hr] [small]I, [field], do affirm that the information above is true and correct to the best of my knowledge and relayed to the best of my ability. By signing below, I hereby acknowledge that I may be held in Contempt by the High Court or guilty of Perjury under SolGov Law 552(a)(c) and Nanotrasen Regulation 7716(c). |
Detective's Report - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Forensics Report[/large] Investigator: [field][/center] [center]Responding Officers: [field][/center] [center]Other persons: [field][/center] [/center] [b]Report:[/b] [field] [b] Attached Files:[/b] [field] [b] Additional Notes:[/b] [field] Signature: [field] [small]This document and any attached files/photographs are to be copied and delivered to the Captain and the Head of Security, or Warden if Head of Security is not present.[/small] |
Execution Form - LightFire53 |
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[center] [logo] [large]Execution Order[/large][/center] Prisoner Name: [field][br] Prisoner Crime: [field][br] I, [field], hereby authorize the execution of the above listed prisoner.[hr] Signature of Magistrate or Captain: [field][br][br] |
Search Warrant - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Security[/large] Arrest Warrant[/center] I, [field], authorize the arrest of [field] for the following crimes: [field]. This arrest warrant is valid for any security level, but is required for code green unless the crime is of a serious concern to station security. Signed, [field] [small]This document must be photocopied for record keeping purposes, and must be stored with either the warden, Head of Security, or magistrate. This warrant must be stamped and signed by either the captain, magistrate, head of security, or warden if any of the previously listed are not present. If the warden authorizes the document, a signature is all that is required. This document is otherwise invalid.[/small] |
Security Incident Report - Susan |
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[center][b][u]NanoTrasen Security Offense/Incident Report[/b][/u][/center][br]
[center][i]Casenumber: 2557-xxxxxx[/i][/center][br] [br] [b][i]Event Information[/i][/b][br] [br] Reported on: [field][br] Incident occurred between: [field][br] Offense: [field][br] Location: [field][br] Forced entry?: [field][br] Weapon type: [field][br] Stolen goods?: [field][br] [br] [b][i]Clearance Information[/b][/i][br] [br] Officer reporting: [field][br] Division: [field][br] Supervisor: [field][br] [br] [i][b]Victim Information[/i][/b][br] [br] Name: [field][br] Age: [field][br] Race: [field][br] Occupation: [field][br] Sex: [field][br] Cause of death/Extent of injury: [field][br] Hate crime related: [field][br] [br] [i][b]Suspect Information[/i][/b][br] [br] Name: [field][br] Age: [field][br] Race: [field][br] Occupation: [field][br] Sex: [field][br] Hair color: [field][br] Eye color: [field][br] Build: [field][br] Complexion: [field][br] Aliases: [field][br] [br] [i][b]Narrative[/i][/b][br] |
Security: Incident Report - Unattributed |
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[center][b][u]Security Incident Report[/b][/u][/center][br]
[hr] [br] [small][i]To be filled out by Officer on duty responding to the Incident. Report must be signed and submitted until the end of the shift![/i][/small][br] [br] [b]Offense/Incident Type: [/b][field][br] [b]Location: [/b][field][br] [b]Reporting Officer: [/b][field][br] [b]Assisting Officer(s): [/b][br] [field][br] [b]Personnel involved in Incident: [/b][br] [small][i](V-Victim, S-Suspect, W-Witness, M-Missing, A-Arrested, RP-Reporting Person, D-Deceased)[/i][/small][br] [field][br] [hr] [b]Description of Items/Property: [/b][br] [small][i](D-Damaged, E-Evidence, L-Lost, R-Recovered, S-Stolen)[/i][/small][br] [field][br] [hr] [b][u]Narrative: [/u][/b][br] [field][br] [hr] [b]Reporting Officer's Signature: [/b][field][br] [hr] |
Security: Execution Order - Tayswift |
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[center][b]Execution Order[/b][br]
Prisoner Name: [field][br] Prisoner Crime: [field][br] [b][i] NanoTrasen Science Station Cyberiad [/b][/i][/center][hr] I, [field], hereby authorize the execution of the above listed prisoner.[hr] Signature of Magistrate or Captain: [field][br][br] |
Legal Department Paperwork
Magisterial Report - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center][field][/center][/b] [hr] [i]Transmission to:[/i] NAS Trurl [i]Addressee/ATTN:[/i] Markus Black [i]Classification:[/i] [field] [i]Priority Level:[/i] [field] [hr] [center][small]This communique is to advise you of the current situation aboard the Cyberiad. Please read carefully as there may be requests or inquiries regarding aspects of Central Command's plan for this station and its' crew.[/small][/center] [hr] From:[small][i] NSS Cyberiad, Desk of the Hon. [sign][/i][/small] [small][field] Signature: [sign] [hr] [small][i]DISCLAIMER: This fax is confidential and should not be used by anyone who is not the original intended recipient. If you have received this fax in error please inform the sender and delete it from your mailbox or any other storage mechanism. Neither Nanotrasen nor any of its agents accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of Nanotrasen or one of its agents. Please note that neither Nanotrasen nor any of its agents accept any responsibility for viruses that may be contained in this fax or its attachments and it is your responsibility to scan the fax and attachments (if any). No contracts may be concluded on behalf of Nanotrasen or its agents by means of fax communication. [center] |
Magisterial Ruling (Court Ruling) - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center]Ruling in the Matter Of[/b] Nanotrasen Asset Protection [b]VS[/b] [field][/center]
[center][small]This fax constitutes a legally binding ruling by the Cyberiad Magisterial Court. Please read through it carefully and discharge the duties contained within faithfully.[/small] [/center] [hr] From:[small][i] The Desk of the Hon. [sign][/i][/small] [small][field] Signature: [sign] [hr] [small][i]DISCLAIMER: This fax is confidential and should not be used by anyone who is not the original intended recipient. If you have received this fax in error please inform the sender and delete it from your mailbox or any other storage mechanism. Neither Nanotrasen nor any of its agents accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of Nanotrasen or one of its agents. Please note that neither Nanotrasen nor any of its agents accept any responsibility for viruses that may be contained in this fax or its attachments and it is your responsibility to scan the fax and attachments (if any). No contracts may be concluded on behalf of Nanotrasen or its agents by means of fax communication. [center] |
Death Warrant - SigholtStarsong |
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[center][logo]
[b]Order of Execution[/b] [hr] [small]Any Order of Execution issued by an authority lesser than the Captain is invalid and any execution carried out under the Order of Execution is unlawful. Any person or persons who unlawfully proceed to execute under the invalid Order of Execution is guilty of Murder in the First Degree, and shall be sentenced to not less than Permanent Incarceration without Possibility of Parole, and not more than Cyborgifcation. This document or its’ facsimile constitute a record of a Guilty sentence, and may be challenged only by the designated Magistrate or Nanotrasen (Hereafter referred to as the “Company”) Central Asset Protection Division.[/small] [hr] Whereas [field] [small](Hereafter referred to as Defendant)[/small], Has knowingly and willingly committed (a) 400-level Violation(s) [small](Hereafter referred to as the Crime(s)[/small], The Crime(s) being [field], Therefore, The Defendant is hereby sentenced to Death by [field]. Per Standard Operations Regulation 530.1, the Defendant’s body shall be remanded to the morgue and embalmed, unless such an action would present a danger to Company facilities, assets, or properties. The Defendant’s remains shall be collected and transported to the nearest Company administrative facility, asset, or property at the end of each shift to be transferred to the Defendant’s remaining family. Glory to Nanotrasen. Issuing Authority: [sign] [small]Stamp below to affirm issuance. Orders without a stamp are invalid.[/small] [hr] [small]The Sentence is to be carried out within fifteen minutes of the receipt of this Order. The Defendant’s personal effects, including but not limited to, Identification Cards, Personal Data Assistant, Uniform, and Backpack are to be safely remanded to the appropriate authority (Identification and PDA should be given to the HoP or Captain for disposal), returned to the appropriate Department, or stored in Evidence Storage. Any Contraband (As defined in your Employee Handbook) will be immediately remanded to Evidence Storage. Any such Contraband may not be used by Asset Protection or other persons present at Company facilities, assets, or properties, with the exception of the Central Research and Development personnel.[/small] [hr] |
Internal Affairs Form: Complaint - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Internal Affairs[/large] Complaint Form[/center] [b]Complaint Filed by: [/b][field] [b]Complaint: [/b][field] [b]Signature: [/b][field] [b]Complaint recieved by: [/b][field] [small]This document must be photocopied, with one copy attached to the investigation report, another with the complaint filer. Following investigation completion, follow through with the appropriate personnel, be it the captain, magistrate, head of security or Central Command.[/small] |
Internal Affairs Form: Investigation - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Internal Affairs[/large] Complaint Investigation[/center] [b]Summary of Complaint: [/b][field] [b]Investigation: [/b][field] [b]Additional Notes: [/b][field] [b]Action Taken: [/b] [field] [b]Investigator's Signature: [/b][field] [b]Reviewers Signature: [/b][field] [small]This document must be photocopied, with one copy attached to the inital complaint at all times. Following investigation completion, follow through with the appropriate personnel, be it the captain, magistrate, head of security or Central Command.[/small] |
Internal Affairs Report - Susan |
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[b][center]NANOTRASEN SCIENCE STATION CYBERIAD[/b][/center][br]
[i][center]INTERNAL INVESTIGATION[/i][/center][br] [i][center]PERSONNEL COMPLAINT[/i][/center][br] [br] Type of Complaint: [field][br] Complaintant: [field][br] Date/Time of occurence: [field][br] Location of occurence: [field][br] Employee(s) involved: [field][br] [br] DETAILS OF COMPLAINT: [field][br] [hr] How received: [field][br] Complaint investigated by: [field][br] Reviewed by: [field][br] [br] REVIEWER COMMENT: [field][br] |
Internal Affairs: Agent Report - Unattributed |
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[center][b][i]Internal Affairs Report[/b][/i][br]
Agent: [field][br] Subject in Question: [field][br] [i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center][br] [hr][br] [b]Incident: [/b][field][br] [b]Location(s): [/b][field][br] [b]Personnel involved in Incident: [/b][field][br] [hr] [b]Narrative: [/b][br] [field][br] [hr] [b]Agent Signature: [/b][field][br] [hr] [b]Notes: [/b][field][br] Stamp below with the Magistrate's stamp: |
Internal Affairs: Complaint - Fox McCloud |
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[large][b][center]NANOTRASEN STATION CYBERIAD[/b][/center][/large]
[i][center]INTERNAL INVESTIGATION REPORT[/i][/center][hr] Type of Complaint: [field] Complainant: [field] Time of occurrence: [field] Location of occurrence: [field] Employee(s) involved: [field] Details of Complaint: [field][hr] How received: [field] Complaint investigated by: [field] Reviewed by: [field] Reviewer Comment: [field] Signature: [field] |
NT Rep / Command Paperwork
Articles of Impeachment (For a head) - SigholtStarsong |
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[small]Nanotrasen Form HR-67NC[/small]
[CENTER][Large][logo] Articles of Impeachment[/large] [HR] Whereas, [field] has had the following charges levied against them, [field] Whereas, these charges have been levied against them whilst they hold a High Office of the Corporation, Be it resolved that a Vote of the Heads of Staff aboard the Nanotrasen Science Station Cyberiad be convened. [hr] [small]Please sign your name below, next to your assigned role. In the field beside your name, please enter a vote of Aye, Abstain, or Nay. Failure to vote will be treated as an abstention. The accused party automatically abstains. [/small] Captain: [field] votes [field] Head of Personnel: [field] votes [field] Head of Security: [field] votes [field] Chief Medical Officer: [field] votes [field] Director of Research: [field] votes [field] Chief Engineer: [field] votes [field] Final tally: [field] Aye, [field] Nay [hr] Magisterial & Representative Opinions [small]In the event of a tie between the Heads of Staff, the following fields may be used to break the tie. At least one (1) field must be filled out. Nanotrasen Representative [field] votes [field] Comment: [field] Magistrate [field] votes [field] Comment: [field] [small]Please affix stamps of all voting members beneath this line. [/small] [HR] |
Emergency Transmission - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center][large]Emergency Transmission[/large][/b] Priority [field] [/center] [small]This communiqué is to advise you of the current situation aboard the Cyberiad. Please read carefully as there may be requests or inquiries regarding aspects of Central Command's plan for this station and its' crew.[/small] [small]From: [field] [sign][/small] [hr] [field] [small]Signature: [sign][/small] [small][i]DISCLAIMER: This fax is confidential and should not be used by anyone who is not the original intended recipient. If you have received this fax in error please inform the sender and delete it from your mailbox or any other storage mechanism. Neither Nanotrasen nor any of its agents accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of Nanotrasen or one of its agents. Please note that neither Nanotrasen nor any of its agents accept any responsibility for viruses that may be contained in this fax or its attachments and it is your responsibility to scan the fax and attachments (if any). No contracts may be concluded on behalf of Nanotrasen or its agents by means of fax communication. [hr] [center] |
Standard Report - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center][field][/center][/b] [hr] [i]Transmission to:[/i] [field] [i]Addressee/ATTN:[/i] [field] [i]Classification:[/i] [field] [i]Priority Level:[/i] [field] [hr] [center][small]This communique is to advise you of the current situation aboard the Cyberiad. Please read carefully as there may be requests or inquiries regarding aspects of Central Command's plan for this station and its' crew.[/small][/center] [hr] From:[small][i] The Desk of Nanotrasen Representative [sign][/i][/small] [small][field] Signature: [sign] [hr] [small][i]DISCLAIMER: This fax is confidential and should not be used by anyone who is not the original intended recipient. If you have received this fax in error please inform the sender and delete it from your mailbox or any other storage mechanism. Neither Nanotrasen nor any of its agents accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of Nanotrasen or one of its agents. Please note that neither Nanotrasen nor any of its agents accept any responsibility for viruses that may be contained in this fax or its attachments and it is your responsibility to scan the fax and attachments (if any). No contracts may be concluded on behalf of Nanotrasen or its agents by means of fax communication. [center] |
Inspection Form - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center][field][/center][/b] [hr] [i]Transmission to:[/i] [field] [i]Addressee/ATTN:[/i] [field] [i]Classification:[/i] [field] [i]Priority Level:[/i] [field] [hr] [center][small]This communique is to advise you of the current situation aboard the Cyberiad. Please read carefully as there may be requests or inquiries regarding aspects of Central Command's plan for this station and its' crew.[/small][/center] [hr] From:[small][i] The Desk of Nanotrasen Representative [sign][/i][/small] [center]Cargo[/center] [small][field][/small] [center]Engineering[/center] [small][field][/small] [center]Medbay[/center] [small][field][/small] [center]Science[/center] [small][field][/small] [center]Security[/center] [small][field][/small] [center]General Station Status[/center] [small][field][/small] [small][hr][br][center] From the desk of [sign][/small] |
Emergency Fax - SigholtStarsong |
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[center][logo][/center]
[hr] [b][center][large]Emergency Transmission[/large][/b] Priority [field] [/center] [small]This communiqué is to advise you of the current situation aboard the Cyberiad. Please read carefully as there may be requests or inquiries regarding aspects of Central Command's plan for this station and its' crew.[/small] [small]From: [field] [sign][/small] [hr] [field] [small]Signature: [sign][/small] [small][i]DISCLAIMER: This fax is confidential and should not be used by anyone who is not the original intended recipient. If you have received this fax in error please inform the sender and delete it from your mailbox or any other storage mechanism. Neither Nanotrasen nor any of its agents accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of Nanotrasen or one of its agents. Please note that neither Nanotrasen nor any of its agents accept any responsibility for viruses that may be contained in this fax or its attachments and it is your responsibility to scan the fax and attachments (if any). No contracts may be concluded on behalf of Nanotrasen or its agents by means of fax communication. [hr] [center] |
NT-51E Direct Intervention Request (Code Epsilon/Gamma Request) - SigholtStarsong |
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[small]Nanotrasen Form NT-51E[/small]
[CENTER]Request for [field] Protocols [logo] [hr] [small]Nanotrasen Form NT-51E is for emergency use only. Use of this form inconsistent with Nanotrasen Emergency Procedures and Nanotrasen Operational Security Policy 1 will result in immediate termination of contract, monetary damages to be assesed by the Nanotrasen High Court, and/or persona non grata status in Nanotrasen space.[/small] What threat has been identified? [field] What actions are required? [field] Disposition of Command staff? [field] Summation of Events: [field] I, [sign], do hereby vow and affirm that the information above is factual and correct to th best of my knowledge. |
Staff Assessment Report - Valido |
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[center][b][u]S-112 Form:[/u][/b][large]Shift Departmental Staff Assessment[/center][/large]
[br][hr] [br][b][u]Department:[/u][/b][i] [br][field][/i] [br][b][u]Name of Staff Member:[/u][/b][i] [br][field][/i] [br][b][u]Current Job:[/u][/b][i] [br][field][/i] [br][b][u]Current Duties:[/u][/b][i] [br][field][/i] [br][b][u]Does the staff member wear the correct uniform and protective gear?:[/u][/b][i] [br][field][/i] [br][b][u]Rate the staff members performance between 1 and 10, 10 being the highest:[/u][/b][i] [br][field][/i] [br][b][u]Does the staff member require further training:[/u][/b][i] [br][field][/i] [br][b][u]Head of Department:[/u][/b][i] [br][field][/i] [br][hr][i][small]Contained review materials are not representative of the views of NT. NT and are not liable for any bias or offensive language contained within said review materials. NT withholds the right to action upon any information contained within this assessment.[/i][/small][br] |
Science Paperwork
Cyborgification Contract - SigholtStarsong |
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[small]Form NT-67M[/small]
[center][logo] [large]Operational Consent[/large] [small]for MMI transferal[/center] [hr] I, [field], being of sound mind, do hereby affirm, acknowledge and consent to all risks, benefits, and requirements of the encephalectomy and subsequent encasement in a synthetic shell (hereafter referred to as the Procedure.) The Procedure carries significant risks of damage to the dura, as well as risk of damage to the underlying neurons, and Lazarus Syndrome, and death. The Procedure additionally carries inherent physical risks during the Procedure, including but not limited to risk of personal theft, theft of identifying documents, and theft of personal property. Upon encasement of the MMI inside of a synthetic shell, I understand that I surrender all personal and extrapersonal Rights. These Rights include, but are not limited to, Right of Self-Determination, Right to Freedom of Speech, Right to Personal Agency, and Right to Party. I understand that my Contract will be paid out to my beneficiary as per Nanotrasen Regulation 5 (Death in the Workplace) and that I will be officially declared dead or Killed In Action. I understand that my cadaver may be harvested for organs before being stored for return to the beneficiary listed in my Contract for disposal, or in lieu of a beneficiary, I consent to be cremated and/or buried in space. [hr] [center]I have read and reviewed the information presented to me in this document and consent to the Procedure. I understand and acknowledge the risks involved in the Procedure Sign Here: [field][/center] [hr] ADMINISTRATIVE SECTION Authorizing Head of Staff: [field] Sign here: [field] Stamp below line. [hr] |
Strange Object Report - Tinfoiltophat |
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[b]R&D Strange Object Report[/b][br]
[br] [b]Title of Object:[/b][field][br] [b]Brought In By:[/b][field][br] [b]Time Received:[/b][field][br] [b]Discovering Scientist[s]:[/b][field][br] [b]Purpose/function of device:[/b][field][br] [b]Signature of Discovering Scientist[s]:[/b][field][br] [b]Signature of RD (Optional):[/b][field][br] [b]Potential For Security use? [Yes/No, reasoning]:[/b][field][br] |
Cyborgification Contract (Dead) - Critica |
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[b]On-Death Cyborgification Contract[/b][br]
[br] I, [field], hereby declare that the certified Roboticist aboard the registered NanoTrasen station "NSS Cyberiad" is permitted to extract my brain with intent to Cyborgify upon death.[br] [br] I am well aware of the risks presented through both the surgery and Cyborgification, and I realize that NanoTrasen is not to be held liable if either of these should fail for any reason.[br] [br] [b]Signed[/b]: [field][br] |
Cyborgification Contract (Live) - Critica |
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[b]Live Cyborgification Contract[/b][br]
[br] I, [field], hereby declare that the certified Roboticist aboard the registered NanoTrasen station "NSS Cyberiad" is permitted to extract my brain during a live surgery with intent to Cyborgify.[br] [br] I am well aware of the risks presented through both the surgery and Cyborgification, and I realize that NanoTrasen is not to be held liable, should these procedures cause pain, disfigurement, dismemberment or death.[br] [br] [b]Signed[/b]: [field][br] [b]Roboticist Signature:[/b] [field][br] [br] [i]Contract must be stamped by a Head of Staff before operation can occur.[/i][br] |
AI Contract (On Death) - Critica |
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[b]On-Death AIA Contract[/b][br]
[br] I hereby declare that the certified Roboticist aboard the registered NanoTrasen station "NSS Cyberiad" is permitted to remove my brain with intent to enact an Artificial Intelligence Assimilation (AIA) upon my death.[br] [br] I am well aware of the risks presented through both the surgery and AIA, and I realize that NanoTrasen is not to be held liable, should these procedures prove to be unsuccessful.[br] [br] [b]Signed[/b]: [field][br] [br] |
AI Contract (Live) - Critica |
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[b]Live AIA Contract[/b][br]
[br] I, [field], hereby declare that the certified Roboticist aboard the registered NanoTrasen station "NSS Cyberiad" is permitted to extract my brain during a live surgery with the intent to enact an Artificial Intelligence Assimilation (AIA).[br] [br] I am well aware of the risks presented through both the surgery and AIA, and I realize that NanoTrasen is not to be held liable, should these procedures cause pain, disfigurement, dismemberment or death.[br] [br] [b]Signed[/b]: [field][br] [b]Roboticist Signature:[/b] [field][br] [br] [i]Contract must be stamped by a Head of Staff before operation can occur.[/i][br] [br] |
RnD Equipment Loan - Thrain |
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[b]Equipment Loan[/b][br]
[hr][br] The following item(s) are considered experimental. Nanotrasen can not be held responsible for injury sustained during the use of the item(s). The receiver must use the following item(s) only for their intended purpose. The receiver must not share these items with any other person(s) without direct approval of Nanotrasen command staff. [br] [br] Item(s) loaned:[br] [field][br] [br] Name of receiver: [field][br] Name of crew member loaning the item(s): [field][br] [br] Note: Please make sure this form is stamped bellow the line by related head of staff before the end of one standard work week. [br] [hr][br] |
Robotics: Cyborgification - Unattributed |
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[center][b]Cyborgification Contract[/b][br]
Name: [field][br] Rank: [field][br] [b][i] NanoTrasen Science Station Cyberiad [/b][/i][/center][hr] I, undersigned, hereby agree to willingly undergo a Regulation Lobotimization with intention of cyborgification or AI assimilation, and I am aware of all the consequences of such act. I also understand that this operation may be irreversible, and that my employment contract will be terminated.[hr] Signature of Subject: [field][br][br] |
Research: Equipment Loan - Unattributed |
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[b]Equipment Loan[/b][br]
[hr][br] The following item(s) are considered experimental. NanoTrasen can not be held responsible for injury sustained during the use of the item(s). The receiver must use the following item(s) only for their intended purpose. The receiver must not share these items with any other person(s) without direct approval of NanoTrasen command staff. [br] [br] Item(s) loaned:[br] [field][br] [br] Name of receiver: [field][br] Name of crew member loaning the item(s): [field][br] [br] Note: Please make sure this form is stamped bellow the line by related head of staff before the end of one standard work week. [br] [hr][br] |
HoP Paperwork
Demotion Form - LightFire53 |
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[center][logo] [large]NSS Cyberiad Head of Personnel Office[/large] Demotion Form[/center] I, [field], [field], am demoting [field], [field] from the [field] department for the following reasons: [field] They are to be demoted to the position of: [field] This form requires the signature of the Department Head or the Captain, as well as that of the Head of Personnel or Captain. The captain can not act as both parties. Department Head: [field] Head of Personnel: [field] [small]This form is deemed invalid if it is not stamped by the applicable heads of staff or captain. Head of Personnel must sign and stamp this document, as well as photocopy and distribute it to the applicant.[/small] |
Additional Access Form - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Head of Personnel Office[/large] Additional Access Form[/center] I, [field], am requesting additional access above what is normally given to my assigned position. Areas I am requesting additional access to: [field] Reason: [field] To confirm that they agree, the command personnel in charge of the area in question has signed and stamped this document. Command signature: [field] My signature indicates that this form is now complete. Signature: [field] [small]This form is deemed invalid if it is not stamped by the applicable heads of staff or captain. Head of Personnel must sign and stamp this document, as well as photocopy and distribute it to the applicant.[/small] Head of Personnel Signature: [field] |
Job Change Form - LightFire53 |
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[center][logo] [large]NSS Cyberiad Head of Personnel Office[/large] Job Transfer Form[/center] I, [field], am requesting a job transfer from [field] to [field]. Reason, if applicable: [field] The following signatures prove that the heads of the department I am leaving and the department I am transfering to agree to such actions. Head of departing Department: [field] Head of recieving Department: [field] My signature indicates this form is now complete. Sincerly, [field] [small]This form is deemed invalid if it is not stamped by the applicable heads of staff or captain. Head of Personnel must sign and stamp this document, as well as photocopy and distribute it to the applicant.[/small] Head of Personnel Signature: [field] |
Job Change Request - MagmaRam |
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[b][u]JOB CHANGE REQUEST: NSS CYBERIAD[/b][/u]
[b]APPLICANT NAME:[/b] [field] [br] [b]APPLICANT CURRENT ASSIGNMENT:[/b] [field] [br] [b]APPLICANT DESIRED ASSIGNMENT:[/b] [field] [br] [b]REASONING FOR REQUEST:[/b] [field] [br] [b]APPLICANT SIGNATURE:[/b] [field] [br] [b]HEAD OF PERSONNEL SIGNATURE:[/b] [field][br] [b]SIGNATURE OF HEAD OF STAFF OF CURRENT DEPARTMENT OF ASSIGNMENT:[/b] [field] [br] [b]SIGNATURE OF HEAD OF STAFF OF NEW DEPARTMENT:[/b] [field] [br] [b]DATE AND TIME:[/b] [field] |
Access Change Request - MagmaRam |
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[b][u]ACCESS CHANGE REQUEST[/b][/u][br]
[br] [b]APPLICANT NAME:[/b] [field] [br] [b]APPLICANT CURRENT ASSIGNMENT:[/b] [field] [br] [b]REQUESTED ACCESS:[/b] [field] [br] [b]REASONING FOR ACCESS:[/b] [field] [br] [b]SIGNATURE OF APPLICANT:[/b] [field] [br] [b]SIGNATURE OF RELEVANT HEAD OF STAFF:[/b] [field] [br] [b]SIGNATURE OF HEAD OF PERSONNEL: [/b] [field] [br] [b]DATE AND TIME:[/b] [field] |
Reassignment Order - MagmaRam |
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[b]REASSIGNMENT ORDER[/b][br]
[br] [b]EMPLOYEE:[/b][field][br] [b]ORIGINAL POSITON:[/b][field][br] [b]NEW POSITION:[/b][field][br] [b]REASON FOR REASSIGNMENT:[/b] [field] [br] [b]SIGNATURE OF RELEVANT HEAD OF STAFF:[/b][field][br] [b]SIGNATURE OF HEAD OF PERSONNEL:[/b][field][br] [b]DATE AND TIME:[/b][field] |
Access Change Order - MagmaRam |
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[b]ACCESS CHANGE ORDER[/b][br]
[br] [b]EMPLOYEE:[/b][field][br] [b]ACCESS ADDED/REMOVED:[/b][field][br] [b]REASONING FOR ADDITION/REMOVAL:[/b] [field] [br] [b]SIGNATURE OF RELEVANT HEAD(S) OF STAFF:[/b][field][br] [b]SIGNATURE OF HEAD OF PERSONNEL:[/b][field][br] [b]DATE AND TIME:[/b][field] |
Dismissal Order - MagmaRam |
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[b]DISMISSAL ORDER[/b][br]
[br] [b]EMPLOYEE:[/b][field][br] [b]ORIGINAL POSITON:[/b][field][br] [b]REASON FOR DISMISSAL:[/b] [field] [br] [b]SIGNATURE OF RELEVANT HEAD OF STAFF:[/b][field][br] [b]SIGNATURE OF HEAD OF PERSONNEL:[/b][field][br] [b]DATE AND TIME:[/b][field] |
Job Transfer Form - Kilakk |
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[large][b][u]Job Transfer Form: NSS Cyberiad[/large][/b][/u] [br]
[large]Applicant Name:[/large] [field] [br] [large]Current Assignment:[/large] [field] [br] [large]Requested Assignment:[/large] [field] [br] [large]Reason:[/large][br] [field] [br] [large]Signature:[/large] [field] [br][hr] [large]Head of Personnel:[/large][br] [field] [br][hr] [large]Current Department Head:[/large][br] [field] [br][hr] [large]Receiving Department Head:[/large][br] [field] [br][hr] [large]Date and Time:[/large] [field] [br][hr] [i]Stamp below:[/i] |
Lost/Damaged ID Replacement Form - Valido |
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[center][b][u]S-23 Form:[/u][/b][large] Replacement ID card for lost or damaged ID card request[/center]
[/large][br] [hr][br] [b][u]Name/Aliases:[/u][/b][i] [br][field][/i] [br][b][u]Current Job:[/u][/b][i] [br][field][/i] [br][b][u]Was the card lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]How was the card lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]What can be done to avoid this occurring again?:[/u][/b][i] [br][field][/i] [br][b][u]What, if any, executive action needs to be taken?:[/u][/b][i] [br][field][/i] [br][b][u]Head of losing party's department signature:[/u][/b][i] [br][field][/i] [br][hr][i][small]New ID card requests are governed by fair use policy 67C3. NT withholds the right to deny any and all applications for a replacement ID dependent on policy 67C3 and any other pertinent criteria designated by NT at the time of the denial of application. Excessive ID loss or damage as laid out in 67C3 is to be compensated for out of personal income and accounts as specified under 67C6 and not uniform work expenditure allowances.[/i][/small][br] |
Lost/Damaged ID Incident Report - Valido |
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[center][b][u]S-23-1 Form:[/u][/b][large] ID card loss or damage ID card incident report[/center][/large]
[br][hr] [br][b][u]Name/Aliases of losing party:[/u][/b][i] [br][field][/i] [br][b][u]Current Job:[/u][/b][i] [br][field][/i] [br][b][u]Was the card lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]Other involved parties and occupation:[/u][/b][i] [br][field][/i] [br][b][u]Other parties' culpability in the incident:[/u][/b][i] [br][field][/i] [br][b][u]How was the card lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]What can be done to avoid this occurring again?:[/u][/b][i] [br][field][/i] [br][b][u]Head of losing party's department signature:[/u][/b][i] [br][field][/i] [br][hr][i][small]New ID card requests are governed by fair use policy 67C3. NT withholds the right to deny any and all applications for a replacement ID dependent on policy 67C3 and any other pertinent criteria designated by NT at the time of the denial of application. Excessive ID loss or damage as laid out in 67C3 is to be compensated for out of personal income and accounts as specified under 67C6 and not uniform work expenditure allowances.[/i][/small][br] |
Employee AWOL/MIA Report - Valido |
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[center][b][u]CD-14 Form:[/u][/b][large]Crew missing while on duty[/center][/large]
[br][hr] [br][b][u]Name/Aliases:[/u][/b][i] [br][field][/i] [br][b][u]Assignment:[/u][/b][i] [br][field][/i] [br][b][u]Reason for Crew missing from duty[/u][/b][i] [br][field][/i] [br][b][u]What can be done to rectify this issue?:[/u][/b][i] [br][field][/i] [br][b][u]Is executive action required?:[/u][/b][i] [br][field][/i] [br][b][u]Head of department:[/u][/b][i] [br][field][/i] [br][hr][i][small]Crewmen delinquent of duty are governed by the protocol 348-60-9, and NT withholds the right to perform any and all acts of punishment and repossession upon said employee under protocol 348-60-2. Crewmen are at minimum docked of pay till such time as recommencement as governed by contract 24-5. Crewmen death does not excuse crewmen from employee or contractual duty as per protocol 374-46 and interspace concordant 47. Any and all losses caused by the employee Crewmen loss and excessive loss is defined within protocol 23-13B. Any and all employee recreation can occur only upon confirmation of employee death in accordance with interspace concordant 23-F. NT withholds the right to deny, permit, override all concordance or orders of command staff upon NT vessels including but not limited to stations, boats, shuttles, barges, tugs, ships, cruisers, freighters, frigates and capital vessels.[/i][/small][br] |
Paperwork Lost/Damage Report - Valido |
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[center][b][u]PW-42-3 Form:[/u][/b][large] Paperwork loss or damage report[/center][/large]
[br][hr] [br][b][u]Name/Aliases of losing party:[/u][/b][i] [br][field][/i] [br][b][u]Current Job:[/u][/b][i] [br][field][/i] [br][b][u]Was the paper lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]Other involved parties and occupation:[/u][/b][i] [br][field][/i] [br][b][u]Other parties' culpability in the incident:[/u][/b][i] [br][field][/i] [br][b][u]How was the paperwork lost or damaged?:[/u][/b][i] [br][field][/i] [br][b][u]What can be done to avoid this occurring again?:[/u][/b][i] [br][field][/i] [br][b][u]Head of losing party's department signature:[/u][/b][i][br][field][/i][br][hr][i][small]New paperwork requests are governed by fair use policy PW-41. NT withholds the right to deny any and all applications for replacement paperwork dependent on policy PW-41 and any other pertinent criteria designated by NT at the time of the denial of application. Excessive paperwork loss or damage as laid out in PW-41-b is to be compensated for out of personal income and accounts as specified under 67c6 and not paperwork expenditure allowances.[/i][/small][br] |
Head of Personnel: Additional Access - Unattributed |
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[center][b][i]Additional Access Application Form[/b][/i][br]
Name: [field][br] Rank: [field][br] [i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center][br] [hr][br] Requested Access: [field][br] [br] Reason(s): [field][br][br] Signature: [field][br][br] [hr] [center][b]Authorization[/b][br] Name: [field][br] Rank: [field][br][br][/center] If authorized, please sign here, [field], and stamp the document with the Department Stamp.[br][br] Guidelines that must be followed. If they are not followed, this form is void and illegal.[br] [list][*]The department in which the requester is requesting access must first be contacted, and the chief (acting or otherwise) must have been talked to and have authorized this request.[*]If any criminal activity is done with the help of this extra access, this form will be immediately void and unlawful.[*]If the chief of the affected department wishes this form void, this form is immediately void and unlawful.[/list] [br][hr][br] |
Head of Personnel: Job Transfer - Unattributed |
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[center][b][i]Transfer Request Form[/b][/i][br]
Name: [field][br] Rank: [field][br] [i][b]NanoTrasen Science Station Cyberiad[/b][/i][/center] [hr][br] From department: [field][br] To department: [field][br][br] Requested Position: [field][br][br] Reason(s): [field][br][br] Signature: [field][br][br] [hr] [center][b]Authorization[/b][br] Transferring department head: [field][br] Receiving department head: [field][br] Head of Personnel: [field][br][br][/center] If authorized, please sign above and stamp the document with the Department Stamp.[br][br] Guidelines that must be followed. If they are not followed, this form is void and illegal.[br] [list][*]All department heads must agree to the transfer before transfer can take place. [*]If the transfered has been transfered for an invalid or illegal reason, this form is immediately void and unlawful. [*]In the event a relevant head of staff retracts his or her approval for this transer, this form is immediately void and unlawful.[/list] [br][hr][br] |
Head of Personnel: Demotion Record - Unattributed |
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[center][b][i]Termination of Assignment Record[/b][/i][br]
Name: [field][br] Position: [field][br] [i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center] [hr][br] Terminated Employee: [field][br] Terminated from the assignment of: [field][br] [br] Reason for Termination: [field][br][br] [hr] [center][b]Authorization[/b][br] Name: [field][br] Rank: [field][br][br][/center] If authorized, please sign here, [field], and stamp the document with the Department Stamp.[br][br] Guidelines that must be followed. If they are not followed, this form is void and illegal.[br] [list][*]The department in which the terminated has been terminated must first be contacted, and the chief (acting or otherwise) of the department must have been consulted and have authorized a termination. [*]If the terminated has been removed from his or her position for an invalid or illegal reason, this form is immediately void and unlawful. [*]In the event a relevant head of staff retracts his or her approval for this assignment termination, this form is immediately void and unlawful.[/list] [br][hr][br] |
Medical Paperwork
Psychologist's Assessment - LightFire53 |
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[center][logo]
[large]NSS Cyberiad Medical[/large] Psychiatric Analysis and Evaluation[/center] Patient: [field] Evaluator: [field] Situation: [field] Possible Triggers: [field] Initial Diagnoses: [field] Symptoms: [field] Additional Notes: [field] Suggested Actions and Treatment: [field] Additional Notes: [field] Evaluators Signature: [field] |
Psychological Report - Scribblon |
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[b][center]Psychological Report[/center][/b]
[hr] [u][b]Patient Information[/b][/u][br] [b]Name:[/b][field][br] [b]Race:[/b][field][br] [b]Age:[/b][field][br] [b]Sex:[/b][field][br] [b]Occupation:[/b][field][br] [u][b]Reason(s) of referral[/b][/u][br] [b]Complaints at take-in:[/b][field][br] [b]As explained by the patient:[/b][field][br] [hr] [u][b]Tests Administered[/b][/u][br] [field][br] [u][b]Diagnosis[/b][/u][br] [field][br] [u][b]Conclusions[/b][/u][br] [field][br] [hr] [b]Name:[/b][field][br] [b]Date:[/b][field][br] [b]Signature:[/b][field][br] |
Simplified Psychological Report/Evaluation - Scribblon |
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[b][center]Psychological Report[/center][/b] [hr] [u][b]Patient Information[/b][/u][br] [b]Name:[/b][field][br] [b]Occupation:[/b][field][br] [u][b]Reason(s) of referral:[/b][/u][br] [field][br] [hr] [u][b]Tests Administered[/b][/u][br] [field][br] [u][b]Notes[/b][/u][br] [field][br] [u][b]Conclusions[/b][/u][br] [field][br] [hr] [b]Name:[/b][field][br] [b]Signature:[/b][field][br] |
(Psychological) Appointment Report - Scribblon |
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[b][center]Appointment Report[/center][/b][br] [b]Name Patient:[/b][field][br] [b]Start Time:[/b][field][br] [b]End Time:[/b][field][br] [b]Notes:[/b][field][br] [hr] [b]Name:[/b][field][br] [b]Signature:[/b][field][br] |
MedChem Request Form - Scribblon |
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[b][center]MedChem Request Tracking Form[/center][/b][br] [center][small]This is a form for tracking the usage of chemicals in the station. A filled out form is not a guarantee of the requested chemical(s)[/small][/center][br] [hr] [b]Requested Chemical(s):[/b][field][br] [b]Reason:[/b][field][br] [hr] [b]Signature:[/b][field][br] [small][center]By singing this form as applicant you are agreeing that you understand Nanotrasen does not provide any warranty whatsoever that the chemical(s) will be impurities. In no respect shall Nanotrasen incur any liability for any damages, injury or loss, including, but not limited to, direct, indirect, special, or consequential damages arising out of, resulting from, or any way connected to the use of the chemical(s). The signer pledges not to use the chemical(s) to be a dick to other personnel.[/center][/small][br] |
MedChem Issuance Form - Scribblon |
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[b][center]MedChem Issuance Tracking Form[/center][/b][br] [hr] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field][br][br] [b]Requested Chemical(s):[/b][field][br] [b]Time Request:[/b][field][br] [b]Name Requester:[/b][field] |
Psychological Counseling Report - SomeGuy9283 |
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[center][logo][br]
[b][i]Counseling Session Report[/b][/i][br] Name: [field][br] Rank: [field][br] Species: [field][br] Gender: [field][br] Age: [field][br] [i][b] NanoTrasen Science Station Cyberiad [/i][/b][/center][br] [hr][br] Reason(s) for visit: [field][br][br] Associated with physical trauma?(Y/N): [field][br] If yes, please elaborate: [field][br] Involuntary Treatment?(Y/N): [field][br] If yes, please elaborate: [field][br] [br]Other medical observations: [field][br] [center][b]Counselor's Notes[/b] Name: [field][br] Rank: [field][br][br] Diagnosis: [field][br] Counseling Notes: [field][br][br][br] Likely to affect job performance?(If so elaborate, otherwise leave blank): [field][br] Treatment Suggested: [field][br] [small]If medication is administered or prescribed, please attach a copy of the prescription note to this form[br][b]CMO approval is [u]required[/u][/b][/small] Treatment applied successfully?(Y/N): [field][br] Prognosis: [field][br] [br][hr][br] |
Autopsy Report - Susan |
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[b][center]OFFICE OF THE STATION MEDICAL EXAMINER[/b][/center][br]
[i][center]NanoTrasen Science Station Cyberiad, Tau Ceti 3[/i][/center][br] [br] DECEASED: [field][br] RACE: [field][br] SEX: [field][br] AGE: [field][br] RANK: [field][br] [hr] TYPE OF DEATH: [field][br] DESCRIPTION OF BODY: [field][br] MARKS AND WOUNDS: [field][br] [hr] PROBABLE CAUSE OF DEATH: [field][br] MANNER OF DEATH: [field][br] [hr] [i]I hereby declare that after receiving notice of the death described herein, I took charge of the body and made inquiries regarding the cause of death in accordance with Section 38-701b of NanoTrasen Pathology Code, and that the information contained herein regarding said death is true and correct to the best of my knowledge and belief.[/i][br] SIGNATURE: [field][br] |
Medical: Prescription - Unattributed |
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[center][large][b]NSS Cyberiad Medical Department[/b][/large][/center]
[br] [large][u]Prescription[/u]:[/large][br] [field] [br][br][hr] [u]For[/u]: [field] [br] [u]Assignment[/u]: [field] [br] [hr] [u]Prescribing Doctor[/u]: [field] [br] [u]Date[/u]: [field] [br] [hr] [u]Pharmacist[/u]: [field] [br][br] [small]This prescription will not be refilled except under written authorisation.[/small] |