Ill. Admin. Code tit. 77, pt. 500, app G, ILLUSTRATION B
Current through Register Vol. 49, No. 2, January 10, 2025
INSTRUCTIONS: | 1. Prepare this form in triplicate. Use typewriter for all entries except signature. |
2. Sign original and first copy in pen and ink. | |
3. Mail original and first copy to the coroner. Retain last copy. |
Ill. Admin. Code tit. 77, pt. 500, app G, ILLUSTRATION B