| Contact Information | |
|---|---|
| First Name | Nicolas |
| Last Name | Pelletier |
| Address | 887 deboischatel |
| City | st-lazare |
| State | |
| Province | Quebec |
| Zip/Postal Code | J7T2L7 |
| Country | Canada |
| Home Phone | - |
| nicolaspellletier@sympatico.ca | |
| Alternate Email | |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Samuel - |
| Date of Injury | 11/24/98 |
| Type of Injury | Obstetric |