Historical Newspapers of South Carolina

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A Date of Date Reported to Asst. Superir How did the accident happen?. Nature and location of Injury:. IWhat Unsafe Act, Unsaf^T^mh What Corre^^^^^ ? Was First Cf^ ?A W Was injured 1^ Sent to doctor?^^^^ Jn| Asst. Superintendefl^^^^ Since all injuries, no made on every case by the aSI HAND I( ) Left Hand t \ n f a. t* 1 LV ) rvigni nana . CCIDENT F CJ| ^ /CLINTON H ACCIDENT RE1 Age:_ Tim Ltendent: Tim tion, or Defective Equipment Cau l V M? Date:* Super reported and j ^^endent or superinie Lng Middle ndex REPORT PORT 4 Job: e: e: was j a temp*setu Time: Time: Time: intendent: given first aid IMMEDIAT ndent and sent to the nure FO< r Shift: _ A. M P. M. P. M. US^V >rar^ A. M. P. M. A. M P. M. A. M P. M. Date: ELY this report should be le. 3T ? , Little Great Toe ( ) Left Foot ( ) Right Foot