| Contact Information | |
|---|---|
| First Name | Ellen |
| Last Name | Burgan |
| Address | 17415 82nd ct N.E. |
| City | Kenmore |
| State | WA |
| Province | |
| Zip/Postal Code | 98028 |
| Country | United States |
| Home Phone | - |
| Work Phone | - |
| Fax | |
| ellenburgan@comcast.net | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Hannah - Burgan |
| Date of Injury | 06/17/2007 |
| Type of Injury | Obstetric |