Information

  • East Wimmera Health Service

  • Vehicle Damage Report

  • Campus

  • Make:

  • Model

  • Registration

  • Kilometers

  • Location
  • Conducted on

  • Vehicle Identification Photo

Exterior

Body

  • Bonnet

  • Left front guard

  • Right front guard

  • Left front door

  • Right front door

  • Left rear door

  • Right rear door

  • Left sill

  • Right sill

  • Left quarter panel

  • Right quarter panel

  • Boot / lift gate / tail gate

  • Roof

Bumper Bars

  • Front bar

  • Rear bar

Lights

  • Left head light

  • Right head light

  • Left guard flasher

  • Right guard flasher

  • Left tail light

  • Right tail light

  • Centre brake light

  • Number plate lights

Glass

  • Windscreen

  • Left front door glass

  • Right front door glass

  • Left rear door glass

  • Right rear door glass

  • Back window / tail gate glass

  • Station wagon left side glass

  • Station wagon right side glass

Mirrors

  • Left exterior mirror

  • Right exterior mirror

Interior

Seats

  • Left front seat

  • Right front seat

  • Rear seat

  • 7 Seater rear seat

  • Trim

  • Interior mirror

Wheels & Tyre's

Wheels

  • Left front wheel

  • Right front wheel

  • Left rear wheel

  • Right rear wheel

  • Spare wheel

Tyre's

  • Left front tyre

  • Right front tyre

  • Left rear tyre

  • Right rear tyre

  • Spare tyre

Sundries

  • Bonnet protector

  • Left headlight protector

  • Right headlight protector

  • Tow bar

  • Add signature

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