FIRST AID Register

Project Name: Project Location:

Date Type of Injury Body Part Injured Cause of Injury Details of First Aid Medication &
Sl No Time (AM/PM) Name of Injured Age (yrs) Sex (M/F) Company / Contractor ID Number Designation / Trade
(DD/MM/YY) Recommendation.
Refer Table Bellow

Type of Injury Abrasion Amputation Bruise Burn / scald Fracture / Dislocation Cut / Laceration Sprain / Strain Swelling Eye Injury Puncture / Nail Prick Other
Body Part Injured Head Eye Ear Face Neck Shoulder Chest Abdomen Arm Hand Fingers Leg Knee Foot Toe Other
Cause of Injury Fall from Slip / trip / fall - same level Contact with Struck by falling Struck by flying Hit / run-over by eqpt / machinery Hit by hand tool / Contact with hot object Equipment Cut with sharp Use of defective equipment Caught in between Other
height / stairs electricity material material object / flame failure / misuse object