Injury Line: Sterling Business Forms Inc
| Inspection Nr | 309996882 |
| Investigation Nr | 202365821 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Amputation |
| Part of Body | Bodysystem |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Illumination |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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