| Description | Columns arranged in two sections: (1) particulars prescribed under the Workmen's Compensation Act 1925 - full name, address and occupation of injured workman, signature of workman or other person making entry, name of doctor, time and date when entry made, time of accident, date and place where accident, and cause and nature of injury: (2) voluntary information - lamp number, age, married or single, names of witnesses, place to where injured person removed, and by whom reported. |