| Contact Information | |
|---|---|
| First Name | Michelle |
| Last Name | Brockwell |
| Address | 54 Butler Rd |
| City | Plattsburgh |
| State | NY |
| Province | |
| Zip/Postal Code | 12901 |
| Country | United States |
| Work Phone | - |
| Fax | |
| Jasonshelleyashl@aol.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Ashlee - |
| Date of Injury | 12/24/2005 |
| Type of Injury | Obstetric |