Injury Line: Koffler Electrical Mechanical Apparatus Repair Inc
| Inspection Nr | 307398578 |
| Investigation Nr | 201183928 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Abdomen |
| Source of Injury | Water |
| Event Type | Absorption |
| Environmental Factor | Temperature +/- Tolerance Lev. |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Electricians |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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