Witness Statement

We hereby witness the incident of Mr. Rahul Kumar, Steel fitter, age 20 years in T2-02-
P2 on 10th February 2020 at around 5:30 AM. We state that victim was standing on step
ladder while breaking concrete offset. A piece of concrete lump fell on ladder and then
on his leg and victim lost his balance resulting injury in his left ankle.
The above statement furnished by both of us is correct to the best of our knowledge and
belief.

Name of Witness:
1. Bihari Lal (Welder) : Signature

2. Chandramani (Helper) : Signature