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| Inspection Nr | 120490818 |
| Investigation Nr | 909374 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Othbodysys |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Illumination |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Attendants, amusement and recreation facilities |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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