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NOTIFY the DIVISION IMMEDIATELY IF INJURY RESULTS in DEATH 2001
INJURED ON EMPLOYER S PREMISES Please be specific. Identify tools equipment or material the employee was using ACTIVITY TASK ACCIDENT FACTOR AOS OBJECT OR SUBSTANCE THAT DIRECTLY INJURED EMPLOYEE e.g. the machine employee struck against or struck him the vapor or poison inhaled or swallowed the chemical that irritated his skin. In cases of strains the thing he was lifting pulling etc. NATURE OF INJURY PART OF BODY DESCRIBE IN DETAIL THE NATURE OF THE INJURY ILLNESS AND PART OF THE BODY AFFECTED...
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