Injury Line: Providence St. Joseph Medical Center
| Inspection Nr | 120105127 |
| Investigation Nr | 201110541 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Arm-Mult |
| Source of Injury | Chem Liquids/Vapors |
| Event Type | Fall(Same Level) |
| Environmental Factor | Temperature +/- Tolerance Lev. |
| Human Factor | Insuf/Lack/Protcv Wrk Clthg/Equip |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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