| Contact Information | |
|---|---|
| First Name | Ed |
| Last Name | Swift |
| Address | 1103 Fishback |
| City | Leesburg |
| State | OH |
| Province | |
| Zip/Postal Code | 45135 |
| Country | United States |
| Home Phone | 740 - 335-6782 |
| Work Phone | - |
| Fax | |
| ejay44@yahoo.com | |
| Alternate Email | |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Ed - Swift |
| Date of Injury | 10/05/1990 |
| Type of Injury | Traumatic |