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Form 28U - Notice of Accident to Employer - NC.GOV
SEND A COPY OF THIS FORM TO THE EMPLOYER AND CARRIER/ADMINISTRATOR FROM WHOM YOU WERE RECEIVING WORKERS COMPENSATION. SEND THE ORIGINAL TO THE INDUSTRIAL
AFROTC FORM 28, 20120712. PHYSICIAN OR MEDICAL AUTHORITY SIGNATURE. EXAMINATION DATE. 2. AFROTC DETACHMENT. MEDICAL AUTHORITY: (Medical Authority Initials).
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