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Form 7000-1 PAGE1 - Mine Safety and Health Administration

Form 7000-1 PAGE1 - Mine Safety and Health Administration

www.msha.gov

A separate report must be made on each injured person. Item 13. Show the name of the injured person. [Note: In these instructions, "injured person" means a person either injured or ill.] Item 14. Indicate the sex of the injured person. Item 15. Show the date of birth of the injured person. Item 16. Show the last four digits of the injured ...

  Administration, Health, Safety, Mines, Persons, Injured, Mine safety and health administration, Injured person

Guidelines for Field Triage of Injured Patients

Guidelines for Field Triage of Injured Patients

www.cdc.gov

were serious enough to require the injured person to visit a hospital emergency department (ED); 5.4 million (18%) of these injured patients were transported by EMS personnel (9). Ensuring that severely injured trauma patients are treated at trauma centers has a profound impact on their survival

  Persons, Injured, Injured person

Incident Reporting and Investigation Procedure

Incident Reporting and Investigation Procedure

healthandsafety.curtin.edu.au

The injured person, or persons involved in the incident or near hit/miss or identifying the hazard. Supervisors and/or eye witnesses or SHR’s may assist the reporting person where appropriate or necessary. Incident Reporting and Investigation Procedure.IRAIP.DRA. Page 5 of 7 (Issued : Dec 2011) Health and Safety ...

  Reporting, Persons, Injured, Injured person, Reporting person

INFORMATION REQUEST - Virginia

INFORMATION REQUEST - Virginia

www.dmv.virginia.gov

I am the personal representative (guardian, executor, next of kin, etc.) of a person injured or killed in the crash. I am an authorized representative of any insurance carrier reasonably anticipating exposure to civil liability as a consequence of the crash or to which a person has applied for issuance or renewal of a policy of automobile ...

  Virginia, Request, Persons, Injured, Injured person

MISHAP REPORTING 1. INJURED PERSON: IMMEDIATELY …

MISHAP REPORTING 1. INJURED PERSON: IMMEDIATELY

static.e-publishing.af.mil

mishap reporting 1. injured person: immediately inform your supervisor 2. supervisor: complete the air force form 978, supervisor’s mishap report, and notify your unit safety representative.civilians may need to fill out additional cpo forms. 3. unit safety representative: immediately notify unit commander and wing safety, then follow-up with the air force form 978.

  Your, Reporting, Inform, Persons, Injured, Immediately, Reporting 1, Injured person, Immediately inform your

Accident and incident reporting - guideline

Accident and incident reporting - guideline

www.dmp.wa.gov.au

3 Reporting accidents. 3.1 Notification. Where a person suffers an injury as a result of an accident at a mine, and is unable to perform the work being done at the time of the accident, the manager must notify: • the District Inspector for the region in which the mine is situated • if requested by the injured person, the secretary or local

  Reporting, Persons, Injured, Injured person

Accident and Dangerous Occurrences Reporting

Accident and Dangerous Occurrences Reporting

www.hsa.ie

from a work activity if the injured person has had to be taken from the location of the accident to receive treatment in respect of that injury in a hospital or medical facility. For the purposes of these Regulations, ... 6.7 Dangerous occurrences listed in Appendix 1 are required to be reported. 7. Reporting requirements – self-employed and ...

  Reporting, Persons, Injured, Injured person

COMPANY VEHICLE POLICY - MIDDLETON & COMPANY

COMPANY VEHICLE POLICY - MIDDLETON & COMPANY

www.middletoninsurance.com

• Get name, address and phone number of injured person and witnesses if possible. • Exchange vehicle identification, insurance company name and policy numbers with the other driver. • Take a photograph of the scene of accident if possible. • Complete the accident report in your vehicle.

  Your, Persons, Injured, Injured person

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