Call registration card #06909

26.10.2002 — 12-30

For transport:  00                    Brigade 00                 Squad 2575                Telephone

Dispatcher 03

Place of death: ‘03’ ambulance             Cause of the incident- Criminal activity

Street - Botskinsky, 2^nd pr.

Building - 3

The object was taken from

Type of morgue: SMM (forensic medical morgue)

SURNAME/NAME/PATRONYMIC: none

Sex:  M.       Age: 35 yrs          Date of death: 26.10.2002     Time of death:

Type of death: violent                     Cause of death: poisoning

Police: Regional interior ministry Khoroshevsky (#109)

Address: Bldg 40, Khoroshevsky Road                         Telephone: 940-21-78

Sent to: SMM #10

Trip result: brought to morgue

Notes: Dressed in blue jeans, blue underwear, dark-green socks, black boots.  A ring of yellow metal and a black ring.   Distinctive marks: beard and moustache.

Certified copy.

(Stamp)