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| Inspection Nr | 309144681 |
| Investigation Nr | 201692019 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Back |
| Source of Injury | Bodily Motion |
| Event Type | Fall(Same Level) |
| Environmental Factor | Other |
| Human Factor | Insuff/Lack/Housekeeping Program |
| Occupation | Miscellaneous hand working occupations |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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