Injury Line: Kleen-A-Matic
| Inspection Nr | 110071057 |
| Investigation Nr | 943381 |
| Line Nr | 3 |
| Age | |
| Sex |   |
| Nature of Injury | Strain/Sprain |
| Part of Body | Shoulder |
| Source of Injury | Bodily Motion |
| Event Type | Fall(Same Level) |
| Environmental Factor | Other |
| Human Factor | Other |
| Occupation | Occupation not reported |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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