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Worker’s report of injury/disease (Form 6) - WSIB

Finger(s) Left Right Hip. Thigh Knee. Lower leg Left Right Ankle Foot. Toe(s) Other: Are you: Left handed. Right handed 4. Did the accident/illness happen on the employer’s property or work site? yes n. o Specify where it happened (shop floor, warehouse, client/customer site, parking lot, etc.): 5. Did it happen outside the . Province of ...

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Transcription of Worker’s report of injury/disease (Form 6) - WSIB

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