accident report blank
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![Page 1: Accident Report Blank](https://reader036.vdocuments.us/reader036/viewer/2022080317/577c7f661a28abe054a46506/html5/thumbnails/1.jpg)
ACCIDENT REPORT
Project: _______________
Date of the Accident: Time:
Place:
DESCRIPTION OF WHAT HAPPENED/WAS OBSERVED:
What could be happen: YES NO
Injury
Material Damage
Were persons involved
Plants/Equipments Involved:
Probable Causes:
Action to Prevent
Reported by Report Compiled by Checked & Approved byName: Name: Name:
Job Title: Job Title: Job Title:
Signature: Signature: Signature:
Date: Date: Date:
Sr. No: ______