事故调查报告IncidentInvestigationReport
Part
B
Section
3.2
Page
1of3
Instructions:Completethisformassoonaspossibleafteranincidentthatresultsinseriousinjuryorillness.(Optional:Usetoinvestigateaminorinjuryornearmissthatcouldhaveresultedinaseriousinjuryorillness.)
说明：发生事故后应立即填写该报告（该报告也适用于调查可能引起较大伤害或者疾病的轻伤和虚惊事故）Number编号：_________
Thisisareportofa该事故属于:□Death死亡□LostTime损失工时□Dr.VisitOnly厂外就医□FirstAidOnly急救护理□NearMiss虚惊
Dateofincident事故日期:
Thisreportismadeby报告填写人为:□Employee员工□Supervisor主管□EHS□Other其他_________