Injury Line: Harold Eichenbaum Displays, Inc.
| Inspection Nr | 123588857 |
| Investigation Nr | 571935 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Head |
| Source of Injury | Hoisting Apparatus |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Materials Handlg Equip./Method |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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