Applicant: wu82236023, male, 59 years old, an on-the-job employee of Qingjiang Central Health Center in Bazhou District, Bazhong City. I was unfortunately injured at work on October 9th, 20 13/KLOC-0. I was diagnosed as having two teeth: one front tooth and one front tooth. The photograph of the lower incisor said that there was no reserved value from the root, so I pulled out a traumatic crown fracture and two concussion injuries. 1/3 There was no 6CM gap and mouth on the upper lip.

In view of the above situation, it is difficult to eat and speak clearly (air leakage), and the upper lip is stitched 6CM.

In particular, I applied to be a member of the Labor Ability Appraisal Committee of Bazhong Labor Bureau, hoping to do the labor ability appraisal for the applicant!

Submitted to the members of Bazhong Labor Ability Appraisal Committee.

Worker injured at work: wu82236023 (Tel: 5788784) Family member: Yuan.

Legal representative of the company: Obama (tel:13330617185)

20 13 years 1 month 9