Practice Medical

Contact Details
Legal NameBryan Mullally
EmailEmail hidden; Javascript is required.
Phone07789455785
TeamMasters Team
Jersey #47
Date of Birth03/04/1991
Next of Kin DetailsIn the case of emergency, who is the best person to contact
NameMairead mullally
RelationParent
Phone+353 86 809 3060
Travel & Accomodation Details
Travel ArrangementCar (Drove Self)
Inbound Airline
Inbound Airport Code
Inbound Flight #
Landing Date
Outbound Airline
Outbound Airport Code
Outbound Flight #
Departure Date
Car RegistrationAJ68UKG
Who's the Main Driver?
Travel Comments/Details
Hotel / Accommodation NameLenardo Hotel
Others Staying
Hotel / Accomodation Comments
Medical
Medical ConditionsYes
Condition Details

Asthma

Pre-existing injuriesNo
Injury Details
Medication(s)Yes
Medication Details

Antihistamines

AllergiesYes
Allergy Details

Penicillin

Agreements
Authority reporting Approval
  • agreed
Insurance Coverage
  • agreed
Medical Release
  • agreed
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