| Injury Cases Report | |
| For Duration: - |
| Sr. | Injury No. | Date | Time In | Shift | Name | Age | Sex | Emp. No. | Employer | Designation | Division | Department | Station/Lane | Complaints | Examination Findings | Injury Body part | Injury Classification | Treatment | Referral hospital | Remarks | ||||||||
| diff($to)->y; ?> | ||||||||||||||||||||||||||||
| TOTAL: | ||||||||||||||||||||||||||||