| Contact Information | |
|---|---|
| First Name | Eulalee |
| Last Name | Henry |
| Address | 3851 Partition Rd |
| City | Mississauga |
| State | |
| Province | Ontario |
| Zip/Postal Code | L5N 8N2 |
| Country | Canada |
| Home Phone | 905 - 824-3373 |
| Work Phone | 647 - 234-4563 |
| Fax | |
| paulinehenry25@hotmail.com | |
| Alternate Email | |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Zachary - Henry |
| Date of Injury | |
| Type of Injury | Obstetric |