Injury Line: Tri State Inc
| Inspection Nr | 126106988 |
| Investigation Nr | 201055019 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Multiple |
| Source of Injury | Ladder |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Other |
| Human Factor | Other |
| Occupation | Supervisors; handlers,equip-cleaners,laborers nec |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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