| Contact Information | |
|---|---|
| First Name | Amanda |
| Last Name | Rogers |
| Address | 3077 Hwy 316 |
| City | Gray |
| State | LA |
| Province | |
| Zip/Postal Code | 70359 |
| Country | United States |
| mandysamanie@hotmail.com | |
| Alternate Email | acs_sam@yahoo.com |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Amanda - Rogers |
| Date of Injury | 01/24/1978 |
| Type of Injury | Obstetric |