| Contact Information | |
|---|---|
| First Name | mohammed |
| Last Name | ouazzani chahdi |
| Address | 67 avenue moulay rachid appt 1 |
| City | fez |
| State | |
| Province | |
| Zip/Postal Code | 30000 |
| Country | Morocco |
| Home Phone | 212 - 35656540 |
| Work Phone | 212 - 35623614 |
| Fax | 21235623614 |
| wilacop@hotmail.com | |
| Alternate Email | ocm_ma@yahoo.fr |
| Website Address | none |
| Gender | Male |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | mohammed - ouazzani chahdi |
| Date of Injury | 03/14/1968 |
| Type of Injury | Obstetric |