Injury Line: Nicholson Electric Company
| Inspection Nr | 111109849 |
| Investigation Nr | 170060107 |
| Line Nr | 9 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Head |
| Source of Injury | Materials Handlg Eq. |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Position Inapropriate For Task |
| Occupation | Carpenters |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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