Injury Line: Oscar Jimenez Gonzalez Dba Superme Selecto Jimenez
| Inspection Nr | 313454233 |
| Investigation Nr | 201720406 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Amputation |
| Part of Body | Upper Arm |
| Source of Injury | Other |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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