INCIDENT NOTIFICATION FORM
Incident Type*
- Please Select -
KEJADIAN BERBAHAYA/KEBAKARAN/IMPAK ALAM SEKITAR
KEJADIAN NYARIS
KEMALANGAN PEKERJAAN
PENYAKIT/KERACUNAN PEKERJAAN
Category
COMPLAINANT
Location*
Campus*
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GAMBANG
PEKAN
Block*
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Level*
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Location Description*
Occur Date*
Occur Time*
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Time in 24 hour format eg 15:30
Jenis Masa / Timing Type
Waktu Sebenar / Actual Time
Waktu Anggaran / Estimate Time
Description of Accident*
*Maximum 500 characters.
Name
Email
Phone No
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