Injury Line: Forest Manor Inc. D/B/A
| Inspection Nr | 1487472.015 |
| Investigation Nr | 128476.015 |
| Line Nr | 1 |
| Age | 60 |
| Sex | M |
| Nature of Injury |   |
| Part of Body |   |
| Source of Injury |   |
| Event Type | Card-Vasc/Resp Fail. |
| Environmental Factor |   |
| Human Factor |   |
| Occupation | Physical therapists |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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