Document mpr4va1jBde5eda9K3xkaLbQk

ACCJDENT RECORDS AND INJURY RATES For Office Um 0nfy (Enter u Facta bccooa btuUMd) 8 Tompcrvy Total Q Started bung tune Betmod to work. Tub* charge-------- Permanent Partial fj Death or Permuraat Total Q Put cl BodTJlJjy?jlnSr Tuu eharfe Per oeo*t~ba or S, e.lx^.u,loa. Tuns ciuTyri--100 dajfl-- Compuwna I_______________________ McdicJ t 5-Oil*. 319.00 (t. <mlii8ur.il) lamed by Natwaol Safety Council, loo, 4Jt5 North Michigan Atenm* Queue 60611 Fig. 9-2b. The reverse tide of the "Supervisor Accident Report" is filled in by the safety deportment and contains information necessary for computing miury rates If available, cost data are put under Item 9 on this form The information from this report is useful also In safety meetings and In accident analysis work. ifuniRY urmnn of employee Occupi ,,,,,, Packer ,, epattmen. S.D.Snath fnrii>iw) Shipping 845 ifcuntbo) n.,.Empiny.a 9-23 Co. Number Date of loynry 164 2-12 Typo (Pitil Porta, NTocdtndpieurfacrylt>nt) Doy* Chor|od Non-disab. 0 Cocnponiotien ood other coin Onr 0 Unsafe Act Rooirk (R4**nc ttdt mtr lit* bo Olid) None ilMNe 179 23 S3 Fig. 9-3. The "Iniury Record of Employee/' a 4 x 6 in card, for recording injuries. accidents have occurred It is often impos sible to recall with accuracy the details of an accident, and if details are not recorded accurately and completely at the tune of the accident, they may be lost forever Injury record of employee So that a rec ord of the injury experience of each em ployee can be kept, a special form is available (See Fig 9-3 ) Since, after cases are closed, the first-aid report and the supervisor's accident report are filed by agency of injury (type of ma- 9-5