Injury Line: Gomes Tire & Service Center
| Inspection Nr | 301139291 |
| Investigation Nr | 201504685 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Lower Arm |
| Source of Injury | Machine |
| Event Type | Struck By |
| Environmental Factor | Other |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Helpers, mechanics and repairers |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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