. : Victim Sobriety: Injury Type 1 : Hospital ID . : Phys First Name: INFORMATION -# 17 ****** ***** ******** Prompt valid in: FL 000033480 Fmployer' Oper Lic No. . : Race White Height • 0 Misc. ID# . . Other Phone Nbr: Residency Type File Charges . : EFTA00232813 Date: 7/25/06 Time