Chiusura infortunio

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JUVENTUS SOCCER SCHOOLS JSS International Academy

CLOSURE ACCIDENT TAB NAME AND SURNAME

DATE ACCIDENT

AGE BORN

time acc.

JSS COACH

rilief from

FINAL DIAGNOSIS

FINAL TREATMENT

STRUCTURE/ DOCTOR CONSULTED

PROGNOSIS

Recovery activities date Pratice insurance open

G.A. Coach YES

NO

Date

Document delivered in JSS G.A.

Signature JSS Coach

Telephone contacts and talks note

Signatur JSS RAM

Signature JSS HC


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