Injury Line: Carroll'S Tire Warehouse
| Inspection Nr | 123926727 |
| Investigation Nr | 170625875 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Bodysystem |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Motor transportation occuputions n.e.c. |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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