Injury Line: Kip Inc
| Inspection Nr | 316210145 |
| Investigation Nr | 202673356 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Face |
| Source of Injury | Pump/Prime Mover |
| Event Type | Struck By |
| Environmental Factor | Overpressure/Underpressure |
| Human Factor | Other |
| Occupation | Concrete and terrazzo finishers |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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