Injury Line: Rosa'S Block Center
| Inspection Nr | 3182805 |
| Investigation Nr | 804104 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Asphyxia |
| Part of Body | Othbodysys |
| Source of Injury | Dirt/Sand/Stone |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Insuf/Lack/Protcv Wrk Clthg/Equip |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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