by Freshie
13778 images 30 classes
by smart logger
8435 images 16 classes
by EVANGELIN20
546 images 48 classes
ADDRESS_OR_LOCATION_OF_ACCIDENT AUTHORIZED_SIGNATURE BIRTH_DATE CITY CITY1 CITY2 COUNTY DATE_EMPLOYER_NOTIFIED_OF_INJURY DATE_OF_INJURY_OR_ILLNESS DATE_OF_LAST_HIRE DATE_OF_RETURN_TO_WORK DATE_RECEIVED DID_INJURY_OCCUR_ON_EMPLOYER_PREMISES_no DID_INJURY_OCCUR_ON_EMPLOYER_PREMISES_yes EMPLOYEES_OCCUPATION_WHEN_INJURED EMPLOYERS_NAME FATAL_no FIRST_NAME HOME_ADDRESS IS_VALIDITY_OF_CLAIM_DOUBTED_no
1420 images 4 classes