Injury Line: Don Kott Ford
| Inspection Nr | 112230628 |
| Investigation Nr | 170187728 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Abdomen |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck By |
| Environmental Factor | Pinch Point Action |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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