IR /2024

BULLS-EYE SECURITY SERVICES PTE.LTD

No. 23 New Industrial Road #08-08
Solstice Business Centre Singapore 536209
Tel: (65) 6844 4234

Incident Report Form

Nature of Incident : Student injuries
___________________________________________________________________

Location : Grid Mall - O’School(#05 - 01/02)

_____________________________________________________________________

Date : 27/03/2024
____________________ Time : 21:56hrs
________________

Details of Incident:

At 21:56hrs, Assistant Manager kristian from L5 O’School approached SSO Rudy informed that one
_______________________________________________________________________________________________

Of her student, Ms. Magdelene sustained a leg muscle tightness that leads to limitation of movements
_______________________________________________________________________________________________

During dance classes. While SSO Rudy on his way up to L5 O’School, at the same time informed
_______________________________________________________________________________________________

SS Zaki and request for assistant . SSO Rudy and WSO Iza at the location to check the situation
_______________________________________________________________________________________________

Ambulance has been activated by Manager Kristian . Ambulance arrived at 22:10hrs, Casuality
_______________________________________________________________________________________________

Will be send to Tan Tock Seng Hospital .

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

AMBULANCE DETAILS
_______________________________________________________________________________________________

In Charge : SGT3 Alif

_______________________________________________________________________________________________

Central Fire Station

_______________________________________________________________________________________________

Vehicle number : PA 113

_______________________________________________________________________________________________

Plate Number : QX 1234H

_______________________________________________________________________________________________

SS Zaki 27/03/2024
Reporting Officer Name Signature / Date

FOR OFFICE USE ONLY:

OM/OE Name Signature/Date

AAR Form follow up : Yes No AAR Form Date : ______________