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| Inspection Nr | 112404801 |
| Investigation Nr | 14442388 |
| Line Nr | 2 |
| Age | |
| Sex | |
| Nature of Injury | Electric Shock |
| Part of Body | Multiple |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Struck Against |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Laborers, except construction |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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