| Contact Information | |
|---|---|
| First Name | Anisa |
| Last Name | Mesey |
| Address | 727 High Ridge Drive |
| City | Union |
| State | MO |
| Province | |
| Zip/Postal Code | 63084 |
| Country | United States |
| Home Phone | 636 - 583-3767 |
| Work Phone | 636 - 629-4545 |
| Fax | |
| anisam@parway.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Jake - Mesey |
| Date of Injury | 12/25/2000 |
| Type of Injury | Traumatic |