Injury Line: Clayton Industries
| Inspection Nr | 112201405 |
| Investigation Nr | 170190763 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Cut/Laceration |
| Part of Body | Head |
| Source of Injury | Machine |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Insuf/Lack/Protcv Wrk Clthg/Equip |
| Occupation | Machine operators, not specified |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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