McLARENS VIETNAM Co., LTD STATEMENT FORM (BẢN TỰ KHAI)

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NAME (HỌ VÀ TÊN): VĨ MINH TRỊ ID Card No (SỐ CMND): 201577866

ADDRESS (ĐỊA CHỈ ): 74/2 Phan Thanh Street, Danang city, Vietnam.

SEX (GIỚI TÍNH): AGE (TUỔI): NATIONALITY (QUỐC TỊCH): MARITAL STATUS (TÌNH TRẠNG HÔN NHÂN):

……Male…... …26…………… ………Vietnam........................ …Single………………………………………….

EMPLOYER’S NAME AND ADDRESS (TÊN VÀ ĐỊA CHỈ CƠ QUAN LÀM VIỆC):

Angsana Lang Co Hotel and Resort, Cu Du Village, Loc Vinh Commune, Phu Loc District, Thua Thien Hue Province………………

OCCUPATION (CHỨC VỤ ) DATE EMPLOYMENT (NGÀY BẮT ĐẦU HĐ ):

Resort Host …………………………………………………………………. .13 April 2015…………………………………………...

RECORD BY (GHI CHÉP BỞI): DATE (NGÀY): TIME (THỜI GIAN):

VĨ MINH TRỊ 12 April 2016 ……………………….

I hereby declare that the following statement made by me is true and correct to the best of my knowledge and

belief: (Tôi cam đoan những tường trình dưới đây là đúng sự thật và xin hoàn toàn chịu trách nhiệm nếu có sai

trái)

At 19:20 on 22nd July 2015, we received a phone call from Mrs. Devi R. 5210 to inform that her husband has fallen on the floor. I

rush into the guest room, after a few rings and knock, nobody open the door so I used the Master key to open their door. When I

came in, I saw Mr. Pala naked on the ground, next to the sliding door. I’m using walkie talkie to call back to Front Office to

inform the situation and ask for help. Mrs. Devi inform that they already have 2 cocktail in Golf cafe.

Viet Resort Host shortly arrives. He called to inform Security about the case and asking for first aid equipments. We tried to call

Chan May Hospital’s ambulance but no one pick up the hotline. The nurse from Clinic arrive first, but nothing she can do.. Viet

first tries to arrange a vehicle to take Mr. Ravi to the hospital, but the wound is too bad so he can not take the car. Viet called the

managerment of the hotel but Mr. Serge is not there at the moment so he called Mr. Sebastian De Vicaza – Food and Beverage

Manager for help. At 20:20, Mr. Sebastian arrives, we have a short brief with him about the situation.

Meanwhile, Mr. Ravi is burning in pain, he asking for pain relief, but he can not use normal type of pain relief because of crohn’s

disease. According to Mrs. Devi, he only can take morphine or betadine.

We tried to call Hoan My Hospital’s ambulance from Danang but they refuse because it’s too far and they have only one left to

standby there. We keep calling them, finally, at 20:00, they send an ambulance.

Around 20:40, Chan May Hospital arrive but without morphine or Betadine, so we send them back to get some morphine. At

21:20, they’re back to give Mr. Ravi the first shot of morphine. Hoan My’s ambulance arrives 10 minutes later with doctor; 20

minutes later, they successfully start to transfer Mr. Ravi to Hoan My Hospital.

Mrs. Devi get on the ambulance, Viet and Sebastian followed them by an SUV.

SIGNATURE………………………………