KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL
KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL
KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL
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Passengers & Pedestrians<br />
KDOT Form 854 Rev. 1-2009<br />
Unit #<br />
Seat Type<br />
TU<br />
ST<br />
TU<br />
ST<br />
TU<br />
ST<br />
TU<br />
ST<br />
TU<br />
01<br />
Gibbs<br />
18 Kaylie<br />
08/16/1997 Dighton KS 67839<br />
01<br />
Gibbs<br />
18 Kent<br />
08/16/1999 Dighton KS 67839<br />
01<br />
McGee<br />
18 Tony<br />
07/05/2001 Dighton KS 67839<br />
01<br />
PASSENGER Last Name<br />
PASSENGER First Name<br />
McGee<br />
Middle Name<br />
Date of Birth<br />
MN<br />
DOB<br />
MN<br />
DOB<br />
MN<br />
DOB<br />
MN<br />
DOB<br />
LIST ADDITIONAL PASSENGERS BY<br />
TRAFFIC UNIT<br />
2455 W CR190 RD<br />
2455 W CR190 RD<br />
2565 W CR190 RD<br />
2565 W CR190 RD<br />
18 Tommy<br />
02/15/2003 Dighton KS 67839<br />
MN<br />
PASSENGER ADDRESS (Number, Street, Sfx, etc.)<br />
City State Zip<br />
New address?<br />
New address?<br />
New address?<br />
New address?<br />
New address?<br />
Investigating Officer / Badge No.<br />
Nathan Myers<br />
Personal Phone Number<br />
Work Phone Number<br />
Personal<br />
(620) 587-1254<br />
Work<br />
Personal<br />
(620) 587-1254<br />
Work<br />
Personal<br />
(620) 587-5874<br />
Work<br />
Personal<br />
(620) 587-5874<br />
Work<br />
Personal<br />
771 Example 6<br />
Gender<br />
Age<br />
F<br />
15<br />
F<br />
13<br />
M<br />
11<br />
M<br />
09<br />
SE Used<br />
Eject/Trap<br />
Local Case No.<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
Inj Severity<br />
Eject Path<br />
N<br />
P<br />
P<br />
I<br />
Page of<br />
5 6<br />
Transpt Unit<br />
Extrication?<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
TU<br />
MN<br />
New address?<br />
Personal<br />
ST<br />
DOB<br />
Work<br />
Transport<br />
Unit<br />
EMS Time Notified<br />
Injured taken by:<br />
Transport<br />
Unit<br />
EMS Time Notified<br />
Injured taken by:<br />
EMS Arrived<br />
EMS Time@Hosp<br />
Injured taken to:<br />
EMS Arrived<br />
EMS Time@Hosp<br />
Injured taken to:<br />
Transport<br />
Unit<br />
EMS Time Notified<br />
Injured taken by:<br />
Transport<br />
Unit<br />
EMS Time Notified<br />
Injured taken by:<br />
EMS Arrived<br />
EMS Time@Hosp<br />
Injured taken to:<br />
EMS Arrived<br />
EMS Time@Hosp<br />
Injured taken to:<br />
Transport Units: A, B, C, ..., N
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