Injury Line: Home Club
| Inspection Nr | 111974440 |
| Investigation Nr | 170166078 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Back |
| Source of Injury | Other |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Sales workers, hardware and building supplies |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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