Injury Line: Beverly Manor Convalescent Hospital
| Inspection Nr | 111788295 |
| Investigation Nr | 170169205 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Hip(S) |
| Source of Injury | Other |
| Event Type | Fall(Same Level) |
| Environmental Factor | Other |
| Human Factor | Insuf/Lack/Protcv Wrk Clthg/Equip |
| Occupation | Registered nurses |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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