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Injury Report
Injury Report
CLIN-REP-003A
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Injury Report Revised Date 0
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Struck by flying/thrown object Struck against object Caught in/under object Rubbed/abraded by object
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A fall Machinery/vehicle accident Repetitive motion Electric Shock
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Temperature extremes
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Bodily reaction Blood/fluid exposure Toxic material exposure Other disease exposure
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Noise extremes
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Doctor/Nurse HR Manager Factory Manager Director