Injury Line: Mtb Builders, Inc
| Inspection Nr | 124425943 |
| Investigation Nr | 14303036 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Head |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Carpenters |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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