| Contact Information | |
|---|---|
| First Name | Stephen |
| Last Name | Bates |
| Address | 8019 Walker Street |
| City | Philadelphia |
| State | PA |
| Province | |
| Zip/Postal Code | 19136 |
| Country | United States |
| Home Phone | 215 - 338-4810 |
| Work Phone | - |
| Fax | |
| dbate2you@yahoo.com | |
| Alternate Email | dbate2you@comast.net |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Stephen - Bates |
| Date of Injury | 9/03/2005 |
| Type of Injury | Traumatic |