Accident Report

Boiler Details

Boiler Registration No.
Boiler Address
Located District

Sight / Serius Injury Details

Cause of Accident
Damage to boiler
Yes
No
Damage to steam pipe
Yes
No
Injury caused to any person
Yes
No
Accident detail
Accident date

Organisation Details

Applicant Name
Designation
Organisation Name
Email Id
Mobile No
Quick Links
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