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6 October Time of accident 11:00 Place of accident
Construction site
Karl was standing on a pile of pipes directing the crane driver offload pipes from a truck. His cellphone rang and he reached into his pocket, overbalanced and fell. His safety hat flew off and his head hit the edge of a pipe, causing a wound.
The Safety Officer stopped the bleeding and called the paramedics. He was placed on a stretcher and taken to hospital.
(65 words)
Results of the medical examination
Name of compiler
Signature of compiler
The doctor put 11 stitches in Karl’s head wound and checked that he didn’t have concussion. Karl was kept overnight in hospital for observation.
(24 words) Position of compiler Construction worker Date 7 or 8 October 20..