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Brgy Detail
Brgy Detail
Brgy. __________________________
Period Covered: ____________________
VICTIM'S DATA SUSPECT'S DATA STATUS OF CASE
CIVIL STATUS
CIVIL STATUS
Date and Time Date and Time
Blotter Entry # Reported Committed Offense Committed With Certificate
Settled For Conciliation
NAT
NAT
AGE
AGE
SEX
SEX
NAME NAME For Record
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