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Accident Report cf210148

The document is an accident report form completed by Mohamad Shahrol Dinie regarding an incident that occurred on August 8, 2022, involving a collision between a motorcycle and a car in Pulau Pinang. The victim, Mohd Hakim, sustained multiple injuries, including open cuts and a broken leg, and was transported to the hospital. Recommendations for future prevention include introducing motor paths and building barricades to reduce the risk of similar accidents.

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Amirul Husni
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24 views1 page

Accident Report cf210148

The document is an accident report form completed by Mohamad Shahrol Dinie regarding an incident that occurred on August 8, 2022, involving a collision between a motorcycle and a car in Pulau Pinang. The victim, Mohd Hakim, sustained multiple injuries, including open cuts and a broken leg, and was transported to the hospital. Recommendations for future prevention include introducing motor paths and building barricades to reduce the risk of similar accidents.

Uploaded by

Amirul Husni
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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This page is to be attached together with the student’s answer script.

Name: Mohamad Shahrol Dinie Bin Mohd Sharil Suresh _________ Matric Number: CF210148______

ACCIDENT / INCIDENT REPORT FORM


SECTION I: WITNESS INFORMATION (2 marks)
NAME: Mohamad Shahrol Dinie Bin Mohd Sharil Suresh

HOME ADDRESS: Blok A-18-15 Mutiara Heights Jelutong 11600 Pulau Pinang
____________________________________________________________________________________________
Telephone Number: (018)4036762_____________________ Age: 24 Date of Birth: 18/081999

SECTION II: ACCIDENT/INCIDENT DATA (13 marks)

No of Injury: 1

DATE of Accident /Incident: Sunday 8 TIME of Accident /Incident: 10 – 11AM 10:22 AM


August 2022

Accident /Incident occurred at: Jalan Air Itam Pulau Pinang.

Specific Location of Accident: Jalan Masjid Negeri Air Itam Pulau Pinang.

Briefly explain what happened:


(if an injury, (1) explain activities occurring when injury or illness occurred and what tools, machinery, chemicals, were involved, (2) what happened to
cause this injury or illness (3) what was the injury or illness (i.e., state the part of body affected and how it was affected)

1) Victim Mohd Hakim collided with oncoming traffic (car).

2) Victim’s mode of transportation (motorcycle) was heavily damaged.

3) The 23 year old suffered open cuts and bruises obtained on parts of body including right shoulder, waist, right hand, right
leg was broken on scene.

4) Victim was quickly brought to the nearest hospital by emergency services.

What action was taken:

1) Those injured were sent to Hospital Besar Pulau Pinang.

2) Section of the road was closed temporarily to clear the mess that may have been there which may disrupt the safety of other
traffic users.

Include specific details on how it was mediated, how the incident can be avoided in the future:

1) The police arrived at the scene to mediate the flow of traffic due to the mess that were on the road after the accident.
2) Motor path should be introduce to reduce and prevent accidents between motorcycles and cars.
3) Barricade between two oncoming roads should be built to prevent any future head on collision between two high speed
vehiclesor more. (2 x 1 mark = 2)

Completed by: Mohamad Shahrol Dinie Date: 12 August 2022

* Note: ( ) indicates the allocated marks.

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