| Contact Information | |
|---|---|
| First Name | George |
| Last Name | Krouse |
| Address | 15340 CO. Rd. 12 |
| City | Pengilly |
| State | MN |
| Province | |
| Zip/Postal Code | 55775 |
| Country | United States |
| Home Phone | - |
| Work Phone | - |
| Fax | |
| gakrouse@scicable.com | |
| Alternate Email | |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | George - Krouse |
| Date of Injury | 01/15/1960 |
| Type of Injury | Obstetric |