Title Page
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Document No.
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Prepared by
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Location
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Site:
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Date reported:
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Person who reported the incident to Mega Homes:
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Date & time incident occurred:
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Brief description of the incident:
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Type of incident
Details of the injured person
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Name:
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Date of Birth:
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Contact number
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Employer:
Incident Details
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Full details of the incident:
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Immediate actions taken:
