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Prepared for The NIOSH Mountain and Plains Education and Research Center (MAP ERC)

Funding Source: This publication was supported by Grant Number 1T42OH009229-01 from CDC NIOSH Mountain
and Plains Education and Research Center. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of CDC NIOSH and MAP ERC.

Appendix A: Wyoming
Report of Injury Form

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Page 2:

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Wyoming Workers' Safety and Compensation Injury Report Code Tables:

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