Injury Line: Cloverleaf Enterprises
| Inspection Nr | 300055407 |
| Investigation Nr | 200050706 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Head |
| Source of Injury | Buildings/Structures |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Other |
| Occupation | Roofers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
Translate