Seafarer Injury Assessment Documentation
Seafarer Details
Full Name
Rank / Position
Crew ID / Personal Number
Date of Birth
Nationality
Incident Details
Date of Incident
Time of Incident
Location (on vessel)
Brief Description of Incident
Injury Assessment
Type/Nature of Injury
Part(s) of Body Affected
Description of Injuries
Immediate Actions Taken
Medical Assessment
Vital Signs
Assessment by Medical Personnel/Officer
Treatment Provided
Recommended Follow-up or Referral
Additional Information
Witness Names (if any)
Remarks / Other Notes
Date of Documentation
Medical Personnel/Officer Name
Signature