| Contact Information | |
|---|---|
| First Name | Amanda |
| Last Name | Wiggin |
| Address | 24 St Lawrence Dr |
| City | Belmont |
| State | NH |
| Province | |
| Zip/Postal Code | 03220 |
| Country | United States |
| Work Phone | - |
| Fax | |
| nhnativeamerican2003@yahoo.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Jamie - Wiggin |
| Date of Injury | 3-10-05 |
| Type of Injury | Obstetric |