Chip Hitware 10

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Text File | 1998-01-05 | 24.1 KB | 4,251 lines

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4.233337 -1 0 Times New Roman 9.75 0 0 0 0 lbl_TInp 24.99433 282.9986 176.001 4.233337 -1 0 Times New Roman 9.75 0 0 0 0 lbl_TInp 144.9918 275.0082 2.998614 4.233337 -1 0 Times New Roman 9.75 0 0 0 0 lbl_TInp 173.0024 275.0082 2.998614 4.233337 -1 0 Times New Roman 9.75 0 0 0 0 lbl_TInp 24.99433 268.0056 118.0043 11.00668 -1 0 Times New Roman 9.75 0 0 0 0 lbl_Text 0 24.07711 5.027088 Unternehmen/Beh÷rde 0 0 Arial 8.25 0 0 0 0 24.07711 0 0 lbl_Text 0 24.07711 12.9646 Betrieb/Niederlassung/Amt 0 0 Arial 8.25 0 0 0 0 24.07711 0 0 lbl_Text 0 155.046 6.085423 Ausfertigung fⁿr -1 0 Arial 9.75 0 0 0 0 155.046 0 0 lbl_Text 0 154.9931 10.05418 Betriebsrat -1 0 Arial 9.75 0 0 0 0 155 0 0 lbl_Text 0 123.0314 12.9646 Postleitzahl, Ort, Datum 0 0 Arial 8.25 0 0 0 0 123.0314 0 0 lbl_Text 0 123.0314 20.9021 (ONKz) Telefon-Nebenstelle 0 0 Arial 8.25 0 0 0 0 123.0314 0 0 lbl_Text 0 166.9523 20.9021 Unser Zeichen 0 0 Arial 8.25 0 0 0 0 166.9523 0 0 lbl_Text 0 24.07711 83.07925 Meldung eines Arbeits- oder Dienstunfalls -1 0 Arial 12 0 0 0 0 24.07711 0 0 lbl_Text 0 128.0585 57.94381 Anzeige 0 0 Arial 8.25 0 0 0 0 128.0585 0 0 lbl_Text 0 150.0189 57.94381 Vermerk 0 0 Arial 8.25 0 0 0 0 150.0189 0 0 lbl_Text 0 128.0585 66.93965 Wegeunfall zum Dienst 0 0 Arial 8.25 0 0 0 0 128.0585 0 0 lbl_Text 0 171.9793 66.93965 Wegeunfall vom Dienst 0 0 Arial 8.25 0 0 0 0 171.9793 0 0 lbl_Text 0 171.9793 50.0063 Sondermarkierung 0 0 Arial 8.25 0 0 0 0 171.9793 0 0 lbl_Text 0 171.9793 56.09172 Abeits- 0 0 Arial 8.25 0 0 0 0 171.9793 0 0 lbl_Text 0 192.0877 56.09172 Dienst- 0 0 Arial 8.25 0 0 0 0 192.0877 0 0 lbl_Text 0 192.0877 59.00214 Unfall 0 0 Arial 8.25 0 0 0 0 192.0877 0 0 lbl_Text 0 171.9793 59.00214 Unfall 0 0 Arial 8.25 0 0 0 0 171.9793 0 0 lbl_Text 0 128.0585 74.87716 Stra▀enverkehrsunfall 0 0 Arial 8.25 0 0 0 0 128.0585 0 0 lbl_Text 0 171.9793 71.96674 Typischer Winterunfall 0 0 Arial 8.25 0 0 0 0 171.9793 0 0 lbl_Text 0 171.9793 74.87716 Fbl 965 104 000-4 beifⁿgen 0 0 Arial 6.75 0 0 0 0 171.9793 0 0 lbl_Text 0 171.9793 76.99383 (Winterzusatzfragebogen) 0 0 Arial 6.75 0 0 0 0 171.9793 0 0 lbl_Text 0 124.8835 79.90424 TAB 0 0 Arial 8.25 0 0 0 0 124.8835 0 0 lbl_Text 0 146.0501 79.90424 Mitglieds-Nummer 0 0 Arial 8.25 0 0 0 0 146.0501 0 0 lbl_Text 0 24.07711 88.90009 Verletzte(r) Name, Vorname, und Anschrift 0 0 Arial 8.25 0 0 0 0 24.07711 0 0 lbl_Text 0 80.96258 89.95842 (Stra▀e und Hausnummer, Postleitzahl, Wohnort, Telefon) 0 0 Arial 6 0 0 0 0 80.96258 0 0 lbl_Text 0 146.0501 88.90009 Personalnummer 0 0 Arial 8.25 0 0 0 0 146.0501 0 0 lbl_Text 0 24.87086 102.1293 Geburtsdatum o. Vers. Nr. 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 64.02923 102.1293 Personalgruppe 0 0 Arial 8.25 0 0 0 0 64.02923 0 0 lbl_Text 0 97.10218 102.1293 Geschlecht 0 0 Arial 8.25 0 0 0 0 97.10218 0 0 lbl_Text 0 98.95426 105.0397 mΣnnlich 0 0 Arial 8.25 0 0 0 0 98.95426 0 0 lbl_Text 0 123.0314 105.0397 weiblich 0 0 Arial 8.25 0 0 0 0 123.0314 0 0 lbl_Text 0 170.921 102.1293 Staatsangeh÷rigkeit 0 0 Arial 8.25 0 0 0 0 170.921 0 0 lbl_Text 0 144.9918 102.1293 - Nur bei AuslΣndern - 0 0 Arial 6.75 0 0 0 0 144.9918 0 0 lbl_Text 0 24.87086 110.0668 RegelmΣ▀ig eingesetzt als 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 146.0501 110.0668 AufgabentrΣger-Nr. /DSt-OZ/ASt-OZ 0 0 Arial 8.25 0 0 0 0 146.0501 0 0 lbl_Text 0 24.87086 118.0043 Bei dieser TΣtigkeit seit 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 56.09172 118.0043 (Monat, Jahr) 0 0 Arial 6.75 0 0 0 0 56.09172 0 0 lbl_Text 0 74.0834 118.0043 BeschΣftigungsstelle/-ort 0 0 Arial 8.25 0 0 0 0 74.0834 0 0 lbl_Text 0 24.87086 125.9418 Bei dieser BeschΣftigungsstelle seit 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 73.02507 125.9418 (Monat, Jahr) 0 0 Arial 6.75 0 0 0 0 73.02507 0 0 lbl_Text 0 97.10218 125.9418 Befristeter Arbeitsvertrag 0 0 Arial 8.25 0 0 0 0 97.10218 0 0 lbl_Text 0 98.95426 129.1168 Nein 0 0 Arial 8.25 0 0 0 0 98.95426 0 0 lbl_Text 0 134.9376 125.9418 Wenn ja, vom - bis 0 0 Arial 8.25 0 0 0 0 134.9376 0 0 lbl_Text 0 161.1314 125.9418 (Tag, Monat, Jahr) 0 0 Arial 6.75 0 0 0 0 161.1314 0 0 lbl_Text 0 24.87086 133.8793 Lohnfortzahlung bis 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 24.87086 137.0543 (Tag, Monat, Jahr) 0 0 Arial 6.75 0 0 0 0 24.87086 0 0 lbl_Text 0 64.02923 133.8793 Unfallzeitpunkt 0 0 Arial 8.25 0 0 0 0 64.02923 0 0 lbl_Text 0 84.93134 133.8793 (Datum, Uhrzeit) 0 0 Arial 6.75 0 0 0 0 84.93134 0 0 lbl_Text 0 115.0939 133.8793 Arbeitszeit / Dienstschicht am Unfalltag 0 0 Arial 8.25 0 0 0 0 115.0939 0 0 lbl_Text 0 115.0939 137.0543 Beginn 0 0 Arial 8.25 0 0 0 0 115.0939 0 0 lbl_Text 0 161.1314 137.0543 Ende 0 0 Arial 8.25 0 0 0 0 161.1314 0 0 lbl_Text 0 124.8835 137.0543 (Datum, Uhrzeit) 0 0 Arial 6.75 0 0 0 0 124.8835 0 0 lbl_Text 0 169.0689 137.0543 (Datum, Uhrzeit) 0 0 Arial 6.75 0 0 0 0 169.0689 0 0 lbl_Text 0 24.87086 147.1085 Der /Die Verletzte hat die Arbeit /den Dienst 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 29.10419 155.046 nicht aufgenommen 0 0 Arial 8.25 0 0 0 0 29.10419 0 0 lbl_Text 0 69.05632 155.046 nicht eingestellt 0 0 Arial 8.25 0 0 0 0 69.05632 0 0 lbl_Text 0 94.98551 151.0772 eingestellt am 0 0 Arial 8.25 0 0 0 0 94.98551 0 0 lbl_Text 0 114.0355 151.0772 (Datum, Uhrzeit) 0 0 Arial 6.75 0 0 0 0 114.0355 0 0 lbl_Text 0 144.9918 147.1085 Arbeits- /DienstunfΣhigkeit 0 0 Arial 8.25 0 0 0 0 144.9918 0 0 lbl_Text 0 150.0189 155.046 Nein 0 0 Arial 8.25 0 0 0 0 150.0189 0 0 lbl_Text 0 160.0731 151.0772 Ja, vom - bis 0 0 Arial 8.25 0 0 0 0 160.0731 0 0 lbl_Text 0 157.9564 160.0731 - auch bei WegeunfΣllen - 0 0 Arial 6.75 0 0 0 0 157.9564 0 0 lbl_Text 0 24.87086 160.0731 Unfallstelle 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 29.10419 164.0418 innerhalb des BetriebsgelΣndes 0 0 Arial 8.25 0 0 0 0 29.10419 0 0 lbl_Text 0 29.10419 173.0377 au▀erhalb des BetriebsgelΣndes 0 0 Arial 8.25 0 0 0 0 29.10419 0 0 lbl_Text 0 76.99383 160.0731 genaue Orts- und Stra▀enangabe, Hausnummer, GebΣudeteil 0 0 Arial 8.25 0 0 0 0 76.99383 0 0 lbl_Text 0 180.9752 147.1085 (Datum) 0 0 Arial 6.75 0 0 0 0 180.9752 0 0 lbl_Text 0 29.10419 180.9752 Ja 0 0 Arial 8.25 0 0 0 0 29.10419 0 0 lbl_Text 0 24.87086 178.0648 bei WegeunfΣllen 0 0 Arial 6.75 0 0 0 0 24.87086 0 0 lbl_Text 0 46.03754 178.0648 Ist der unmittelbare Weg eingehalten worden ? 0 0 Arial 8.25 0 0 0 0 46.03754 0 0 lbl_Text 0 56.09172 180.9752 Zweifelhaft (Wegeskizze beifⁿgen) 0 0 Arial 8.25 0 0 0 0 56.09172 0 0 lbl_Text 0 107.9501 178.0648 Wenn nein, Begrⁿndung; ggf. auf besonderem Blatt 0 0 Arial 8.25 0 0 0 0 107.9501 0 0 lbl_Text 0 24.87086 186.0023 Ausfⁿhrliche Schilderung des Unfallhergangs -1 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 153.9877 186.0023 Angabe des Arbeitsbereichs, unfallaus- 0 0 Arial 8.25 0 0 0 0 153.9877 0 0 lbl_Text 0 92.07509 186.0023 (ggf. auf bes. Blatt oder ErgΣnzung durch Skizze/Foto). 0 0 Arial 6.75 0 0 0 0 92.07509 0 0 lbl_Text 0 24.87086 188.9127 l÷senden Gegenstands, TΣtigkeit des Verletzten zur Zeit des Unfalls; Bewegung des Verletzten; Bewegung des Gegenstands 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 24.87086 224.1023 Wer hat von dem Unfall zuerst Kenntnis genommen 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 91.01675 224.1023 (Name, Anschrift) 0 0 Arial 6.75 0 0 0 0 91.01675 0 0 lbl_Text 0 24.87086 232.0398 Name und Anschrift der Unfallzeugen 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 24.87086 239.9773 Polizeiliche Untersuchung ? 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 29.10419 243.9461 Nein 0 0 Arial 8.25 0 0 0 0 29.10419 0 0 lbl_Text 0 65.08756 239.9773 Ja, Anschrift und Aktenzeichen der Staatsanwaltschaft oder Polizei 0 0 Arial 8.25 0 0 0 0 65.08756 0 0 lbl_Text 0 24.87086 247.9148 Techn. Einrichtung, an der sich der Unfall ereignet hat 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 94.98551 247.9148 (Art, Hersteller, Typ und Baujahr) 0 0 Arial 6.75 0 0 0 0 94.98551 0 0 lbl_Text 0 24.87086 256.1169 Welche techn. Schutzvorrichtung oder -ma▀nahme war getroffen ? 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 24.87086 264.0544 Welche pers÷nliche Schutzausrⁿstung hat die /der Verletzte benutzt ? 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 144.9918 264.0544 - Nur bei Kfz- /KradunfΣllen - -1 0 Arial 6.75 0 0 0 0 144.9918 0 0 lbl_Text 0 144.9918 266.9648 Wurde Sicherheitsgurt benutzt/Schutzhelm getragen ? 0 0 Arial 6.75 0 0 0 0 144.9918 0 0 lbl_Text 0 150.0189 274.1086 Ja 0 0 Arial 8.25 0 0 0 0 150.0189 0 0 lbl_Text 0 178.0648 274.1086 Nein 0 0 Arial 8.25 0 0 0 0 178.0648 0 0 lbl_Text 0 24.87086 278.8711 Welche techn., organisatorischen oder aufklΣrenden Ma▀nahmen sind oder werden getroffen, um Σhnliche UnfΣlle kⁿnftig zu vermeiden ? 0 0 Arial 8.25 0 0 0 0 24.87086 0 0 lbl_Text 0 133.6147 41.01046 Eingangsstempel 0 0 Arial 6.75 0 0 0 2 143 0 0 lbl_Text 0 200.0076 6.085423 1 -1 0 Arial 11.25 0 0 0 0 200 0 0 lbl_Line 0 23.00113 99.00718 12.99987 12.99987 1 0 lbl_Line 0 23.00113 99.00718 21.00794 21.00794 1 0 lbl_Line 0 122.0083 206.0048 21.00794 21.00794 1 0 lbl_Line 0 122.0083 206.0048 30.00378 30.00378 1 0 lbl_Line 1 164.9943 164.9943 21.00794 30.00378 1 0 lbl_Line 0 122.0083 205.017 63.00617 63.00617 1 0 lbl_Line 0 122.0083 205.017 72.00201 72.00201 1 0 lbl_Line 0 122.0083 205.017 79.99244 79.99244 1 0 lbl_Line 0 122.0083 205.017 89.00592 89.00592 1 0 lbl_Line 1 164.9943 164.9943 54.99811 79.99244 1 0 lbl_Line 0 164.9943 204.9994 54.99811 54.99811 1 0 lbl_Line 1 144.004 144.004 79.99244 117.9866 1 0 lbl_Line 0 23.00113 204.9994 102.0058 102.0058 1 0 lbl_Line 0 23.00113 204.9994 109.9962 109.9962 1 0 lbl_Line 0 23.00113 204.9994 118.0043 118.0043 1 0 lbl_Line 0 23.00113 204.9994 125.9947 125.9947 1 0 lbl_Line 0 23.00113 204.9994 134.0028 134.0028 1 0 lbl_Line 1 63.00617 63.00617 102.0058 110.0139 1 0 lbl_Line 1 92.99232 92.99232 102.0058 110.0139 1 0 lbl_Line 1 73.00743 73.00743 118.0043 126.0123 1 0 lbl_Line 1 92.99232 92.99232 125.9947 134.0028 1 0 lbl_Line 1 134.0028 134.0028 128.9933 133.9851 1 0 lbl_Line 0 23.00113 204.9994 147.0026 147.0026 1 0 lbl_Line 1 158.9971 158.9971 138.9946 147.0026 1 0 lbl_Line 0 23.00113 204.9994 160.0025 160.0025 1 0 lbl_Line 1 144.004 144.004 147.0026 160.0025 1 0 lbl_Line 1 158.9971 158.9971 151.9945 160.0025 1 0 lbl_Line 1 93.99773 93.99773 151.9945 160.0025 1 0 lbl_Line 0 23.00113 204.9994 177.9942 177.9942 1 0 lbl_Line 0 23.00113 204.9994 186.0023 186.0023 1 0 lbl_Line 1 105.9922 105.9922 177.9942 186.0023 1 0 lbl_Line 1 76.00605 76.00605 164.9943 177.9942 1 0 lbl_Line 0 23.00113 204.9994 223.9965 223.9965 1 0 lbl_Line 0 23.00113 204.9994 232.0045 232.0045 1 0 lbl_Line 0 23.00113 204.9994 239.995 239.995 1 0 lbl_Line 0 23.00113 204.9994 248.003 248.003 1 0 lbl_Line 1 63.00617 63.00617 242.9936 247.9854 1 0 lbl_Line 0 23.00113 204.9994 255.9935 255.9935 1 0 lbl_Line 0 23.00113 204.9994 264.0015 264.0015 1 0 lbl_Line 0 23.00113 204.9994 278.9946 278.9946 1 0 lbl_Line 1 144.004 144.004 264.0015 278.9946 1 0 lbl_Line 0 122.0083 125.0069 31.99698 31.99698 1 0 lbl_Line 0 122.0083 125.0069 53.00491 53.00491 1 0 lbl_Line 0 160.0025 163.0011 53.00491 53.00491 1 0 lbl_Line 0 160.0025 163.0011 31.99698 31.99698 1 0 lbl_Line 1 122.0083 122.0083 31.99698 34.99559 1 0 lbl_Line 1 122.0083 122.0083 50.0063 53.00491 1 0 lbl_Line 1 163.0011 163.0011 31.99698 34.99559 1 0 lbl_Line 1 163.0011 163.0011 50.0063 53.00491 1 0 lbl_Rahm 23.00113 89.00592 99.00718 .2645836 1 0 0 16777215 lbl_Rahm 122.0083 54.99811 .2645836 34.00781 1 0 0 16777215 lbl_Rahm 122.0083 54.99811 43.00365 .2645836 1 0 0 16777215 lbl_Rahm 164.9943 47.00769 .2645836 8.008063 1 0 0 16777215 lbl_Rahm 164.9943 47.00769 40.00504 .2645836 1 0 0 16777215 lbl_Rahm 122.0083 57.99672 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 164.9943 50.0063 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 144.004 57.99672 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 164.9943 57.99672 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 164.9943 66.99257 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 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242.9936 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 23.00113 287.0027 181.9982 .2645836 1 0 0 16777215 lbl_Rahm 144.004 274.0028 4.99181 4.99181 1 0 0 16777215 lbl_Rahm 171.997 274.0028 4.99181 4.99181 1 0 0 16777215