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Line 1 (UXO Report)
Date-Time Group
Line 2 (UXO Report)
Report Activity and Location
Line 3 (UXO Report)
Contact Method
Line 4 (UXO Report)
Type of IED/Ordanance
Line 5 (UXO Report)
Possible CBRN contamination
Line 6 (UXO Report)
Target/Resources Threatened
Line 7 (UXO Report)
Imapact of mission
Line 8 (UXO Report)
Protective measures/evacuation
Line 9 (UXO Report)
Recommended Priority (immediate, indirect, minor, no threat)
Line 1 (Medevac 9-Line)
Location of site (give coordinates)
Line 2 (Medevac 9-Line)
Radio frequency and call sign
Line 3 (Medevac 9-Line)
Number of patients by precedence (A-urgent, B-urgent surgical, C-priority, D-routine, E-convenience)
Line 4 (Medevac 9-Line)
Special equipment required (A-None, B-hoist, C-extraction equipment, D-ventilator)
Line 5 (Medevac 9-Line)
Number of patients by type (L-litter, A-ambulatory)
Line 6 (Medevac 9-Line)
Security of pickup site (N-no possible enemy troops in the area, P-possible enemy troops in the area, E-enemy troops in the area approach with caution, X-enemy troops in the area armed escort required)
Line 7 (Medevac 9-Line)
Method of marking pickup site (A-panels, B-pyrotechnical signal, C-smoke signal, D-none, E-other)
Line 8 (Medevac 9-Line)
Nationality and status of casualties (A-US military, B-US civilian, C-Non-US military, D-Non-US civilian, E-Other)
Line 9 (Medevac 9-Line)
CBRN contamination (N-nuclear, B-biological, C-chemical)