Injury Line: Moose Lake State Hospital
| Inspection Nr | 14924559 |
| Investigation Nr | 14446918 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Face |
| Source of Injury | Heat (Envir/Mech) |
| Event Type | Other |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Other |
| Occupation | Cooks, except short order |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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