Injury Line: Las Vegas Street Rods
| Inspection Nr | 114567878 |
| Investigation Nr | 885053 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Strain/Sprain |
| Part of Body | Back |
| Source of Injury | Working Surface |
| Event Type | Fall(Same Level) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Insuff/Lack/Housekeeping Program |
| Occupation | Automobile mechanics |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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