Describe how the accident happened and what was the injury:叙述事故发生情形及员工受伤情况
Action Taken:( Please state which hospital/clinic the injured employee was sent to for medicaltreatment and who escorted the injured employee, etc.)
采取的措施: (请叙述受伤员工被送往哪家医院/医务室诊治，由谁陪同，等等）
Doctor's Recommendation : 医生建议
Measures to avoid future occurrence:今后如何避免事故再次发生
Employee's Signature当事人签名 Reporting/Signature of the Witness见证人/事故报告者签名
Signature of Inspector
督察员 Dept./Div. Head部门总监/经理签字
HRD./HR&Adm.M
人力资源总监/行政人事经理 Distribution: 分发
HR Division - White人力资源部 - 白联
HR&Adm.V.G.M 行政人事副总经理G.M./B.G.M
总经理/分公司总经理
Concerned Dept.- Yellow 相关部门 - 黄联
Finance Division - Pink财务部 - 粉联
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