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| Inspection Nr | 111903480 |
| Investigation Nr | 170195903 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Fracture |
| Part of Body | Elbow(S) |
| Source of Injury | Working Surface |
| Event Type | Fall(Same Level) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Maids and housemen |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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