| Name | Description | Type | Additional information |
|---|---|---|---|
| Injured Party Type Name | string |
None. |
|
| Name of Involved Person | string |
None. |
|
| Age | integer |
None. |
|
| Residential Address | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| Zip | string |
None. |
|
| Phone Number | string |
None. |
|
| Injuries resulted in Fatality? | string |
None. |
|
| Date of Fatality * | date |
None. |
|
| Was individual hospitalized? | string |
None. |
|
| Hospital Name | string |
None. |
|
| Hospital Address | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| Zip | string |
None. |
|
| Phone Number | string |
None. |
|
| Fax | string |
None. |
|
| Doctor Name | string |
None. |