第1页共10页襄阳市工伤认定申请书申请人：_____________________________________________________________单位名称：___________________________________________________________单位地址：___________________________________邮政编码：_______________单位法定代表人：____________________________单位：_______________事故发生时间：_______________________________________________________事故发生地点：_______________________________________________________事故发生过程：_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________证人1：（姓名、与受伤人关系）_________________________________证人2：（姓名、与受伤人关系）___________________________________________证人3：（姓名、与受伤人关系）______第2页共10页__________________________________现将受伤情况向人社部门反映，提出工伤认定申请，请求人社部门受理为盼。此致襄阳市人力资源和社会保障局附件：申请工伤认定申请材料：1、工伤认定申请表2、受伤后初次诊断证明（职业病诊断证明）和原始病历等治疗资料3、有关证人材料或证据4、劳动合同文本或其他建立劳动关系的有效证明5、用人单位营业执照复印件6、身份证复印件张贴区受伤害人...
