C. L. 94: Emergency Room's First Report of Injury - Standard Form

Department of Industrial Accidents (DIA)

This government document is issued by Department of Industrial Accidents (DIA) for use in Massachusetts

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File Details: PDF (124 KB)
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https://www.mass.gov/doc/c-l-94-emergency-rooms-first-report-of-injury-standard-form/download?_ga=2.225908250.1854129817.1751542062-2000327536.1747311789&_gl=1*73xmoi*_ga*MjAwMDMyNzUzNi4xNzQ3MzExNzg5*_ga_MCLPEGW7WM*czE3NTE1NDIwNjIkbzY4JGcxJHQxNzUxNTQ1MjQxJGo2MCRsMCRoMA..

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