| Contact Information | |
|---|---|
| First Name | Valerie |
| Last Name | Brown |
| Address | |
| City | Westfield |
| State | IN |
| Province | |
| Zip/Postal Code | 46074 |
| Country | -- |
| Home Phone | - |
| Work Phone | 317 - 655-3468 |
| Fax | |
| vbrpwn0106@aol.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Valerie - Brown |
| Date of Injury | 7/27/2005 |
| Type of Injury | Traumatic |