Injury Line: Kirk & Blum Mfg. Co.
| Inspection Nr | 112354857 |
| Investigation Nr | 781039 |
| Line Nr | 4 |
| Age | |
| Sex |   |
| Nature of Injury | Cancer |
| Part of Body | Head |
| Source of Injury | Working Surface |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Other |
| Occupation | Sheetmetal duct installers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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