| Contact Information | |
|---|---|
| First Name | maryellen |
| Last Name | hoffman |
| Address | 1023 Whitford Dr. |
| City | reading |
| State | PA |
| Province | |
| Zip/Postal Code | 19605 |
| Country | United States |
| Home Phone | 610 - 929 2563 |
| Work Phone | - none |
| Fax | |
| melon1023@earthlink.net | |
| Alternate Email | none |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | maryellen - hoffman |
| Date of Injury | 12 07 1936 |
| Type of Injury | Obstetric |