Injury Line: R.W. Sidley, Inc.
| Inspection Nr | 1242595.015 |
| Investigation Nr | 96619.015 |
| Line Nr | 1 |
| Age | 42 |
| Sex | M |
| Nature of Injury |   |
| Part of Body |   |
| Source of Injury |   |
| Event Type | Fall(From Elevation) |
| Environmental Factor |   |
| Human Factor |   |
| Occupation | Laborers, except construction |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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