Confirmation of community safety

Confirmation of community safety [AmpiTa]

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Name(*)
Safety(*)	1.emergency (Help me!) 2.need rescue 3.want help 4.safe (I can help) 5.safe 6.etc.
Building Damage	1.Building search request(Help me!) 2.Building damage(Danger) 3.Building damage(Caution) 4.Facility damage 4.Minor/No damage 5.Others
Evacuation status	1.continue living at home 2.evacuation shelter (elementary school) 3.evacuation shelter (junior high school) 4.Honganji Temple 5.acquaintance/relative's house 6.hotel etc. 7.overnight in car 8.whereabouts unknown 9.other
Town Council Group	1 2 3 4 5 6 7 8 9 10 11 12
Address (town/street)	Ginza 1-chome Ginza 2-chome Ginza 3-chome Ginza 4-chome Ginza 5-chome Ginza 6-chome Ginza 7-chome Ginza 8-chome Ginza 9-chome Other (please enter a comment)
Address (street number)
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