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| Inspection Nr | 100320654 |
| Investigation Nr | 768531 |
| Line Nr | 3 |
| Age | |
| Sex | |
| Nature of Injury | Fracture |
| Part of Body | Back |
| Source of Injury | Hoisting Apparatus |
| Event Type | Struck By |
| Environmental Factor | Weather, Earthquake, Etc. |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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