| Contact Information | |
|---|---|
| First Name | beverly |
| Last Name | parks |
| Address | p.o. box 553 |
| City | forsyth |
| State | GA |
| Province | |
| Zip/Postal Code | 31029 |
| Country | United States |
| Home Phone | 478 - 994-2624 |
| Work Phone | - |
| Fax | |
| beingmom2kids@bellsouth.net | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | kenny - parks |
| Date of Injury | 09/05/2004 |
| Type of Injury | Traumatic |