Injury Line: W. N. Couch, Inc.
| Inspection Nr | 102424538 |
| Investigation Nr | 775643 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Amputation |
| Part of Body | Head |
| Source of Injury | Metal Products |
| Event Type | Struck By |
| Environmental Factor | Flammable Liq/Solid Exposure |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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