Details of person completing this report
Full name: Chan Mun Yee
Principle/Head Teacher/Teacher/Assistant Teacher (underline relevant category)
Classroom: Hibiscus
Telephone contact number: 016-2234567
Signature: Mun Yee
Date: 17 November 2008
Details of accident/incident
How and why? Loke Mei Chin found a box of matches in the classroom was needed to celebrate her birthday. When the teacher out of the classroom to get the cake from the kitchen, Loke Mei Chin and Lee Huei Juin played with the matches in the classroom. Loke Mei Chin burnt her pointer finger (right hand).
When it happened: Date 17 November 2008 Time 10:15a.m
Where it happened: Hibiscus Classroom
Number of children injured: 1
Details of any person injured
Full name: Loke Mei Chin
Age: 4 years old
Classroom: Hibiscus Classroom
Nature of injury: First-degree burn
First Aid given: Place the burned area in cool water until the pain lessens. Applied ‘Burnol Plus’ antiseptic cream on the burned area.
First Aider: Chan Mun Yee
Taken to hospital – Yes/No
If yes, which hospital and how taken: -
Parents was call – Yes/No pls specify Informed the parents at the end of the day, as this was the first-degree burn which I able to give first aid treatment.
The above accident has been explained and discussed by both provider and the parent/guardian. We agree and understand the accident/guardian describe above. This information has been reported according to the best of our knowledge.
Signature of Parents/Guardians: Chan Carmen Date: 17 November 2008
Signature of Principal: Clyne Wong Date: 17 November