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Get Work Safe BC 55B23 2013-2024

Date of injury or illness (yyyy-mm-dd) a.m. r p.m. r Follow-up report date and time (yyyy-mm-dd) (hh:mm) a.m. r p.m. r a.m. r p.m. r Subsequent report sequence number(s) Time of injury or illness (hh:mm) Initial reporting date and time (yyyy-mm-dd) (hh:mm) Initial report sequence number Description of how the injury, exposure, or illness occurred (What happened?) Description of the nature of the injury, exposure, or illness (What you see — signs and symptoms) Description of the treatment .

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