| Contact Information | |
|---|---|
| First Name | Denise |
| Last Name | Gilanyi |
| Address | |
| City | Union Grove |
| State | WI |
| Province | |
| Zip/Postal Code | 53182 |
| Country | United States |
| Home Phone | - |
| Work Phone | - |
| Fax | |
| dmkz282@yahoo.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Zoe - |
| Date of Injury | 12/01/04 |
| Type of Injury | Obstetric |