Injury Line: Stan Morri Ford Chrysler Plymouth Dodge
| Inspection Nr | 111915187 |
| Investigation Nr | 170173967 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Lower Arm |
| Source of Injury | Hand Tool (Manual) |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Defective Equipment In Use |
| Occupation | Automobile mechanics |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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