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ΔΕΛΤΙΟ ΚΑΤΑΓΡΑΦΗΣ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ

ΔΕΛΤΙΟ ΚΑΤΑΓΡΑΦΗΣ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ

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787 views1 page

ΔΕΛΤΙΟ ΚΑΤΑΓΡΑΦΗΣ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ

ΔΕΛΤΙΟ ΚΑΤΑΓΡΑΦΗΣ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ

Uploaded by

Anonymous wVhDTVO
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

ΔΕΛΤΙΟ ΚΑΤΑΓΡΑΦΗΣ

ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ
ΔΗΜΟΣ: ........................................................................................................................
ΗΜΕΡΟΜΗΝΙΑ: ....................................... ΩΡΑ:.......................................................
ΕΠΩΝΥΜΟ: .................................................................................................................
ΟΝΟΜΑ: .......................................................................................................................
ΗΛΙΚΙΑ: ........................................................................................................................
ΕΙΔΙΚΟΤΗΤΑ: .............................................................................................................

ΣΧΕΣΗ ΕΡΓΑΣΙΑΣ: Δ.Δ. Ι.Δ.Α.Χ. Ι.Δ.Ο.Χ. ΠΡΟΓΡΑΜΜΑΤΑ

ΠΕΡΙΓΡΑΦΗ ΑΤΥΧΗΜΑΤΟΣ:
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................

ΤΕΧΝΙΚΟΣ ΑΣΦΑΛΕΙΑΣ ΓΙΑΤΡΟΣ ΕΡΓΑΣΙΑΣ


ΝΑΙ ΟΧΙ ΝΑΙ ΟΧΙ

ΧΟΡΗΓΗΣΗ ΜΕΣΩΝ ΑΤΟΜΙΚΗΣ ΠΡΟΣΤΑΣΙΑΣ (Μ.Α.Π.)


ΝΑΙ ΟΧΙ

ΑΝΑΓΓΕΛΙΑ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ


ΝΑΙ ΟΧΙ

ΑΠΟΤΕΛΕΣΜΑ ΕΡΓΑΤΙΚΟΥ ΑΤΥΧΗΜΑΤΟΣ:


ΘΑΝΑΤΟΣ (ΑΙΤΙΑ):
.........................................................................................................................................

ΤΡΑΥΜΑΤΙΣΜΟΣ (ΠΕΡΙΓΡΑΦΗ):
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................

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