Innovative Contractors for Advanced Dimensions

Main Contractor: Saudi Bin Ladin Group

Project Name: King Abdullaziz International Airport Development Project -KAIADP-JEDDAH, K.S.A
J-10-421-PF-0 (Terminal Complex, Control Tower & Supporting Facilities)
Contract Title /No.:
J-10-422-PF-0 (Aprons,Taxiways,Roads,Tunnels,Bridges,Load Centers & Infrastructure,
Transportation Center & Supporting Facilities)

FIRST AID TREATMENT FORM

Name : Discipline:

Date of Injury: Time of Injury:

Initial Report Date/Time:

FAC No.

Decription of Injury or Illness (what happened)

Description of the nature of the injury, exposure or illness (What you see signs and symbols)

Description of the treatment given (What you do)

Name of the Witness:

Arrangement made relating to the worker ( return to work/medical aid/follow-up)

Alternate duty options given ( Yes / No, if yes please state)

First Aid Attendant's Name: Patient Signature:

KAIA-QHSE-FRM-0038 R.01