Erick Giuseppe Leon Rodríguez

Reporte Incidente

Reportar incidentes en la empresa

Use this Template

Print as PDF

Use this Template

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Title Page

Realizada por
Área específica
Fecha
Nombre del afectado
Carné
Empresa
Nombre del líder
Nombre testigo

Descripción

Resp. Del contrato Gm
Resp. Contratista
Tipo de incidente
Descripción de la lesión
Parte del cuerpo afectada
Tipo de lesión
Días de incapacidad
Agente causal
Descripción del incidente
Fotografía del evento
Add media
Agente causal
Otras evidencias
Otras evidencias
Causas probables
Acciones inmediatas

Erick Giuseppe Leon Rodríguez

Reporte Incidente

Reportar incidentes en la empresa

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.