Injury Line: C.H. Nickerson & Company, Inc.
| Inspection Nr | 311754949 |
| Investigation Nr | 200083376 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Shoulder |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Squeeze Point Action |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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