| Contact Information | |
|---|---|
| First Name | Fred |
| Last Name | Celik |
| Address | 6809 Columbine |
| City | Crystal Lake |
| State | IL |
| Province | |
| Zip/Postal Code | 60014 |
| Country | United States |
| Home Phone | 815 - 356-1766 |
| Work Phone | 815 - 356-1766 |
| Fax | |
| Simeon2457@comcast.net | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Paula - Celik |
| Date of Injury | 031292 |
| Type of Injury | Obstetric |