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~.-01175-~3 PRINT OR TYPE <br /> <br /> OFFICIAL ACCIDENT REPORT <br /> resulting in injury requiring medical attention or hospitalization to or death of any person, or total damages of <br /> more shall be reported by the investigating officer/operator on this form and forwarded to the MINNESOTA <br />EPARTMENT OF NA~ RESOURCES, Division of Enforcement, 500 Lafayette Road, St. Paul, MN 551554047 <br />stea business days. <br /> :TIONS: 1-800-766-6000 METRO 296-6157 TDD Statewide 1-800-657-3929 TDD METRO 296-5484 <br /> Cpl. R. Kuhn ] (612) 427-6812 Ramsey PD <br />Address of Investigating Department '(No. & Street, P,~D, Box Nol, City, State,' Zip Code) <br /> <br />I15153 Nowthen Blvd. Ramsey, MN 55303 <br /> <br /> Date of Accident {Time [~1 AM I T?,ype .of <br /> I.!2-22-96 I 2125 ~'l~I~asuattY <br /> ~,scrytion of PersOnal injuries <br /> Driver sustained a leg injury co <br />i ,' .... :--'/xrx v, e~.~o, '~ [r~ anx No.. City. State, ZiP'Code) <br /> <br /> ~ Fatal ~ Non- ~ Property County <br /> Fatal r-~ J DamageAnoka <br /> <br />the knee area and could not walk - was transported by amb. <br /> <br />Age <br /> <br />ADULT OPERATOR <br /> <br /> NON MUSA AREA <br /> <br /> NON RESIDENT <br /> <br />[--~ Operator ~ Passenger [--] Pedestrian ['~ Other (eXplain) <br /> <br /> Machine 1 Full Name (First, Middle, Last) D.O.B. injured mate Age <br /> <br /> [7--] Operator [--] Passenger ['-] Pedestrian ~-1 Other (explain) <br /> i (Over) ~ I <br /> <br /> <br />