Injury Line: Sears, Roebuck & Co.
| Inspection Nr | 103157517 |
| Investigation Nr | 14422448 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Head |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Caught In Or Between |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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