Injury Line: 108219 - College Town Pizza Inc
| Inspection Nr | 1780627.015 | 
| Investigation Nr | 170826.015 | 
| Line Nr | 1 | 
| Age | 62 | 
| Sex | M | 
| Nature of Injury |   | 
| Part of Body |   | 
| Source of Injury |   | 
| Event Type | Fall(Same Level) | 
| Environmental Factor |   | 
| Human Factor |   | 
| Occupation | Occupation not reported | 
| Degree of Injury | Fatality | 
| Task Assigned |   | 
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