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| Inspection Nr | 102456456 |
| Investigation Nr | 201952496 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Electric Shock |
| Part of Body | Multiple |
| Source of Injury | Wind/Lightning, Etc. |
| Event Type | Struck By |
| Environmental Factor | Weather, Earthquake, Etc. |
| Human Factor | Other |
| Occupation | Cooks, except short order |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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