FIRST —~ AID CASE REPORTING Please complete this form as a mean to report such FIRST AID CASE. Department/ Location: CIVIL / PRE CAST VARD (of FIRST AID CASE) Date: 22/09/2021 Time: 10:35 ‘Am /[_] Pm’ Hazard Near-Miss [lm FIRSTAID Please check all appropriate conditions: Unsafe Act |__| Unsafe Equipment /Tool |) Unsafe Condition |_| Unsafe use of Equipment / Too! Other Description of First Aid Injury: Rebar got slipped from shoulder while shifting and fell on right knee. Reporting Employee Name: RAJESH MEENA Department: HSE ‘Anonymous (do not want to disclose my name) Signature; Date: 22\a\24 — Investigation Report Describe the condition: Mr. Bappa Karmakar (age 19) got minor injured while handling material manually, bappa was shifting a bunch of four small rebar at precast yard and somehow rebars got slipped from his shoulders and dropped with touching knee. Which cause minor abrasion. He was given volini spray on affected part and sent back to work. Causes (Primary/Conteibuting): Tack of attention Corrective Actions: (Agreed & Implemented) 01 | TAT Conducted among all the workers and explained the case. 02 | Training conducted on Manual material handling by Pradeep singh. ‘Signed: Date Completed a Not Completed for the following reason ‘Safety Department Date: | (Please escalate the report to site head if remains open after target date agreed)