Injury Line: Mid State Industrial Service Inc
| Inspection Nr | 124814195 |
| Investigation Nr | 170132708 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Foot/Ankle |
| Source of Injury | Bodily Motion |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Supervisors; handlers,equip-cleaners,laborers nec |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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