Notice of accident or dangerous occurrence

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.... Number of the injured person : 1. Name of employer : 2. Address of works / premises where the accident or dangerous Occurrence took place : 3. Nature of industry and LIN of the establishment: 4. Branch or department and Exact place where the accident or dangerous occurrence took place : 5. Name and address of the injured person: 6. (a) Gender : (b) Age (at the last birthday....

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....rrence (d) In your opinion, was the injured person at the time of accident or dangerous occurrence - (i) acting in contravention of provisions of any law applicable to them; or (ii) acting in contravention of any orders given by or on behalf of their employer; or (iii) acting without instructions from their employer? (e) In case reply to (d) (i), (ii) or (iii) is i....

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.... took place while meeting emergency, state- (a) its nature; and (b) whether the injured person at the time of accident or dangerous occurrence was employed for the purpose of their employer's trade or business in or about the premises at which the accident or dangerous occurrence took place. : 13. Describe briefly how the accident or dangerous occurrence took place : 14....