Injury Line: Mathis Home Improvements, Inc.
| Inspection Nr | 316112895 |
| Investigation Nr | 200074920 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Back |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Other |
| Human Factor | Mater-Handlg Proced. Inappropr |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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