Injury Line: William H Utz Sr., Builders
| Inspection Nr | 104382783 |
| Investigation Nr | 745265 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Head |
| Source of Injury | Bodily Motion |
| Event Type | Struck By |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Carpenter apprentices |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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