Welsh Ambulance Service NHS Trust - PCS and ACS Operational Journey Sheet Crew Name 1 : Mr Brian Gameson
Pin No.
Driver AM/PM
Call Sign
Crew Name 2 :
Pin No.
Driver AM/PM
Vehicle Reg: KP06 ESU
Sheet 1 Run
of
3
Patient Name
From
Destination
Appt Time
Mob
NP11 6GN 7 Grove Road Risca Newport St Woolos Dialysis Dialysis 8.00 Newport NP20 4SZ
08:00
T1
Ms Pauline Clarke 00297088
NP11 6LD 3 Islwyn Court Risca Newport St Woolos Dialysis Dialysis 7.30 Newport NP20 4SZ
07:30
T1
01
Ms Pauline Fawcett 00261465
NP19 8NZ 18 Rothesay Road Newport
Velindre Hospital Main Outpatients Cardiff CF14 2TL
09:00
T1
02
Velindre Hospital Main Outpatients Cardiff CF14 2TL
09:30
T1
Unk Thamilmani Titus NP20 1EU 41 Emlyn Street Newport 00297293 >>>>>> Chemo Day Unit On 24/06/09
Shift Finish Time Printed : 23/06/2009 15:10:11
Date: 24/06/2009 Wednesday
Speedo Close
Total Mileage Journey Times
Ms Jenny Clarke 00297084
Shift Start Time
Speedo Start
Journey Details
01
02
: SV177
Vehicle Refuelled (Attach Receipt)
Radio Check Time
Esc
Mobile
Arrive
Leave
Dest
Clear
At Base
EMI Signature
1RE
Meal Break Time/Auth Code
Oil Check
Water Check
Tyre Check Equipment Check
Initials
Welsh Ambulance Service NHS Trust - PCS and ACS Operational Journey Sheet Crew Name 1 : Mr Brian Gameson
Pin No.
Driver AM/PM
Call Sign
Crew Name 2 :
Pin No.
Driver AM/PM
Vehicle Reg: KP06 ESU
Sheet 2 Run
of
3
Mob
Esc
Unk Thamilmani Titus Velindre Hospital Main Outpatients 00297294 Cardiff CF14 2TL >>>>>> Chemo Day Unit On 24/06/09
NP20 1EU 41 Emlyn Street Newport
11:00
T1
1RE
Ms Pauline Clarke 00297089
St Woolos Dialysis Dialysis 7.30 Newport NP20 4SZ
NP11 6LD 3 Islwyn Court Risca Newport 12:30
T1
04
Ms Jenny Clarke 00297085
St Woolos Dialysis Dialysis 8.00 Newport NP20 4SZ
NP11 6GN 7 Grove Road Risca Newport 12:00
T1
04
From
Llanfrechfa Grange Hosp Hydrotherapy Cwmbran NP44 8YN
T1
Mrs Sian Jones NP13 1SB 48 Rose Heyworth Road 00297303 Abertillery >>>>>> (01495 212007)
Shift Start Time Shift Finish Time Printed : 23/06/2009 15:10:11
Date: 24/06/2009 Wednesday
Speedo Close
Total Mileage Journey Times
Appt Time
05
Speedo Start
Journey Details Destination
03
Patient Name
: SV177
Vehicle Refuelled (Attach Receipt)
Radio Check Time
13:30
Mobile
Arrive
Leave
Dest
Clear
At Base
EMI Signature
1RE
Meal Break Time/Auth Code
Oil Check
Water Check
Tyre Check Equipment Check
Initials
Welsh Ambulance Service NHS Trust - PCS and ACS Operational Journey Sheet Crew Name 1 : Mr Brian Gameson
Pin No.
Driver AM/PM
Call Sign
Crew Name 2 :
Pin No.
Driver AM/PM
Vehicle Reg: KP06 ESU
Sheet 3 Run
06
of
3
Patient Name
Shift Finish Time Printed : 23/06/2009 15:10:11
Speedo Start
Date: 24/06/2009 Wednesday
Speedo Close
Total Mileage
Journey Details From
Mrs Sian Jones Llanfrechfa Grange Hosp Hydrotherapy 00297304 Cwmbran NP44 8YN >>>>>> (01495 212007)
Shift Start Time
: SV177
Journey Times
Destination
Appt Time
Mob
Esc
NP13 1SB 48 Rose Heyworth Road Abertillery
15:00
T1
1RE
Vehicle Refuelled (Attach Receipt)
Radio Check Time
Meal Break Time/Auth Code
Mobile
Arrive
Oil Check
Leave
Dest
Water Check
Clear
At Base
Tyre Check Equipment Check
EMI Signature
Initials