| Contact Information | |
|---|---|
| First Name | Lisa |
| Last Name | Rose |
| State | TX |
| Work Phone | - |
| Fax | |
| lmrose3@yahoo.com | |
| Alternate Email | |
| Website Address | myspace.com/lilferie |
| Gender | Female |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Lisa - Rose |
| Date of Injury | 01/25/05 |
| Type of Injury | Traumatic |