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| Inspection Nr | 126200567 |
| Investigation Nr | 202479713 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Hernia |
| Part of Body | Back |
| Source of Injury | Bodily Motion |
| Event Type | Rep. Motion/Presure |
| Environmental Factor | Materials Handlg Equip./Method |
| Human Factor | Other |
| Occupation | Laborers, except construction |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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