Injury Line: J X K Construction Corp.
| Inspection Nr | 126938000 |
| Investigation Nr | 170075105 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Puncture |
| Part of Body | Abdomen |
| Source of Injury | Working Surface |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Catch Point/Puncture Action |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Hand molders and shapers, except jewelers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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