____ 10. Death involving abusive use of drugs.
____ 11. Injury which was the direct result of the performance of duty.
____12. Injury involving admission to a hospital.
____ 13. Death of a USAR member on active duty training.
____ 14. Self-inflicted injuries or suicide.
____ 15. Death while a passenger in an aircraft.
____ 16. SITUATION: SP5 Linda M. Ackers, SSN, 292-55-4444, is killed in an
automobile accident in Kansas City, MO on 10 Aug 198X. She was in Co. C, 3rd Bat, 1st
Brigade, Ft. Leavenworth, KS 67421. She was taken to St. Lukes Hospital in Kansas City,
MO where she was dead on arrival at 1215. She died of chest injuries when her car was
hit by a transport truck, she had not been drinking. The attending physician was Dr. F. G.
You work in the Munson Army Community Hospital, Patient Administration
Division, Box 680, Ft. Leavenworth, KS 67421. Prepare a DA Form 2173 for SP5 Ackers.
A blank DA Form 2173 is on the following page.