ii) . . . . . . . . . a. .,......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..*........... iii) ..,...........,...........* . . . . . . . . . . . . . ,..,... * . . . . . . . . . . . . ...**.. 4J Damage to the machinery: Item Nature of damage How it occurred Value of the damage in Rs. i) ..,.................,..,.,......................,................,. ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii) . . . . . . . . . . . . . . ..*.................................................. 4 Loss of life and iimb to the employees of the organization : i) Was there any loss in human life? YES/NO ii) If “YES” how many deaths? Male . . . . . . . . - . . . . .*,..*..........,............,*.*.......... Female . . . . . . . . . . ..I......................................... iii) How did it happen?, . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv) Was any one handicapped physically ? YES/NO 4 If “YES” how many? M~e..............,.................,...............,........ Female .,.,.........,......,.........................,....... 