September 14, 2022 at 8:40 PM
Sample 1
[spoiler]
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('59', 'Husband', 'Jon Perkinson', '417-11-5296', '1/13/71', 'Male', '24411 Gulf Bay rd', 'orange beach', 'al', '36561', '', '251 223-6522', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('61', 'self', 'Anthony Kennon', '424-86-7182', '01/08/1957', 'Male', 'PO Box 3150', 'Orange Beach', 'Alabama', '36561', '251-981-9036', '251-747-8282', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('63', 'Husband', 'Nickolas Todd', '419118239', '12/12/1970', 'Male', '4332 Barclay Place', 'Pace', 'FL', '32571', '8509827730', '8507770122', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('65', 'Patient', 'Michele Turner', '293-70-1405', '11-04-1966', 'Female', '5262 Crowson Rd', 'Pensacola', 'FL', '32526', '850-941-2578', '850-449-2396', '850-475-3721');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('67', 'self', 'Mary J. Ziemba', '267901134', '08/01/1950', 'Female', '204 Mirabelle Circle', 'Pensacola', 'FL', '32514', '', '850-516-1817', '850-863-6580');
[/spoiler]
Amount of records 1093
Price 150
Sample 2
[spoiler]
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42713', '42709', '45521 state hwy 74, space63', '', 'hemet ', 'CA', '92544', '9513057193', '[email protected]', '', '', '9512699877');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42715', '42711', '', '', '', 'AZ', '', '9282008533', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42717', '42713', '43430 E. Florida Ave. PMB 281', '', 'Hemet', 'CA', '92544', '951 852-0780', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42719', '42715', '1462 burns lane', '', 'san jacinto', 'CA', '92583', '9515302228', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42721', '42717', '1462 burns lane', '', 'san jacinto', 'CA', '92583', '9515302228', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42723', '42719', '20710 Havenhurst Dr. Box 1127', '', 'Nuevo', 'CA', '92567', '951-581-2838', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42725', '42721', '2349 VERSAILLES', '', 'SAN JACINTO', 'CA', '92583', '951-260-3706', '[email protected]', '', '', '951-206-8475');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42727', '42723', '5001 W Florda Ave SP 573', '', 'Hemet', 'CA', '92545', '9513455525', '[email protected]', '', '', '951-652-2811');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42729', '42725', '36274 Chittamwood Ln.', '', 'Murrieta', 'CA', '92562', '(951) 600-5740', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42731', '42727', '30383 lamplighter lane', '', 'menifee', 'CA', '92584', '951 2460153', '[email protected]', '', '', '951 7190869');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42733', '42729', '30383 lamplighter lane', '', 'Menifee', 'CA', '92584', '951 2460153', '[email protected]', '', '', '951 7190869');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42735', '42731', '853 w mayberry ave', '', 'hemet', 'CA', '92543', '9515707007', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42737', '42733', '1299 lucerne dr', '', 'hemet', 'CA', '92543', '9513506085', '[email protected]', '', '', '9513506085');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42739', '42735', '1299 lucerne dr', '', 'hemet', 'CA', '92543', '9513506085', '[email protected]', '', '', '9513506085');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42741', '42737', '39785 KNOLLRIDGE DR.', '', 'TEMECLA', 'CA', '92591', '951-775-8851', '[email protected]', '', '', '951-672-7041');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42743', '42739', '28686', '', 'Menfiee', 'CA', '92584', '951 634-6856', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42745', '42741', '28686 Sunridge Ct.', '', 'Menfiee', 'CA', '92584', '951- 634-6856', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42747', '42743', '', '', '', 'AZ', '', '9282009070', '[email protected]', '', '', '');
[/spoiler]
Amount of records 21371
Price 200
Sample 3
[spoiler]
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1769', '1767', '1', '4/6/10', '', 'Timothy W. Moman', '419-82-2400', '45', '08/05/1964', '4425 county rd. 26', 'Boaz', 'Al.', '35957', '256-505-1388', 'TSTech Boaz Al 35957', 'assembly worker', '6y 11m', '256-593-9399', '', '', 'none known', '', '', '', '', '', 'Jordan Martin', 'Dr. Angela Clifton', '256-840-4571', 'Boaz ', 'Al', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'Self', 'Same', 'Same', 'Same', 'Same', 'Same', 'BC/BS', '', 'PPA858932901', '04-01-2006', 'Timothy W. Moman', '4425 co. rd. 26', '08-05-1964', '419-82-2400', 'Self', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'no', 'M', 'DIV', 'No', 'no', 'no', 'no', 'Unknown', 'Mid Knuckle and Ring Knuckle on rt. hand want to lock when closed. Ring Knuckle on lt. hand same as rt.', '2010-04-06 11:59:31', '2010-04-06 11:59:31', '0', '0', '1419 summerchase ln.', 'Albertville', 'Al', '35951', '256-293-9787', 'Same', '[email protected]', '14779', '');
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1771', '1769', '1', '4/6/2010', '', 'Donnie Driver', '424922112', '45', '04/18/1964', '1028 Windsor Parkway', 'Moody', 'AL', '35004', '205.640.3703', 'Verizon Wireless / 400 Riverhills Business Park Suite 445 Birmingham, AL 35242', 'Analyst', '5 yrs', '205.994.5223', 'Sherry Driver', '', 'None', '09/17/1960', '417989213', 'Quality Business Solutions', '205.640.3703', 'Owner', 'Heather Driver (Daughter)', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'Donnie Driver', '1028 Windsor Parkway ', 'Moody', 'AL ', '35004', '205.640.3703', 'BCBS', 'PO BOX 37010 Louisville, KY 40233-7010', 'EZVAN2442383', '01/01/2010', 'Donnie Driver', '1028 Windsor Parkway Moody, AL 35004', '04/18/1964', '424922112', 'Patient', '', '', '', '', '', '', '', '', '', '3/24/2010', '', '', '', '', '', 'no', 'M', 'M', 'no', 'no', 'no', 'no', 'Dog jumped on elbow while arm was stretched out', 'Elbow was hyperextended', '2010-04-06 13:49:36', '2010-04-06 13:49:36', '0', '0', '112 Little Creek Cirle', 'Chelsea', 'AL', '35043', '205.678.7437', 'Patient', '[email protected]', '003330004', '');
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1773', '1771', '1', '04/06/2010', '', 'Austin Hardy', '417513318', '10', '11/17/1999', '5413 Saddle Ridge Ln', 'Pinson', 'Al', '35126', '205-680-9192', 'Kermit Johnson Elementary, Pinson , Al', 'Student', 'N/A', 'N/A', 'N/A', '', '', '', '', '', '', '', '', '', '', '', '', 'Bryan Hardy', '5413 Saddle Ridge Ln.', 'Pinson', 'Al', '35126', '205-680-9192', 'Rhonda Hardy', '5413 Saddle Ridge Ln', 'Pinson', 'Al.', '35126', '205-680-9192', '11/14/1963', '11/05/1969', '422863305', '422987642', 'UAB Hospital', 'ENT Assoc of al', 'Anesthesia Tech', '934-3833', '591-8260', 'Medical ass\'t', '6th Ave So.', 'B\'ham', 'Al', '35294', 'Bryan Hardy', '5413 Saddle Ridge Ln', 'Pinson', 'Al', '35126', '680-9192', 'Viva', 'P.O. Box 55926', '11016774', '01/01/2003', 'Bryan Hardy', '5413 Saddle Ridge Ln', '11/14/1963', '422863305', 'father', '', '', '', '', '', '',
[/spoiler]
Amount of Records 1503
Price
150
Sample 4
[spoiler]
NSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1877', 'Married', 'White', 'Non Hispanic or Latino', '', '[email protected]', 'Binnie', 'A', 'Hughes', 'Binnie', '265-66-7495', '2-1-1943', '', '4040 Schaag Rd', 'Cantonment', 'Fl', '32533', '850-587-2107', '850-512-7504', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1879', '', 'White', 'Non Hispanic or Latino', 'n/a', '[email protected]', 'Bobby', 'J', 'Windsor', 'Bob', '419-48-3519', '6/19/40', 'Male', '671 lakeview drive', 'DFS', 'FL', '32433', '850-892-2690', '850-585-0596', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1881', 'Married', 'White', 'Non Hispanic or Latino', '1999', '[email protected]', 'Richard', 'G', 'DaVico', '', '565-51-4153', '3-11-1963', 'Male', '1513 Hunter\'s Creek Drive', 'Cantonment', 'FL', '32533', '(850)9688-1013', '(850)512-4422', '(850)937-4345');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1883', 'Single', '', '', '04\\03\\16', '[email protected]', 'Martina', 'L', 'Woodard', 'Martina', '217-68-4875', '01\\03\\58', 'Female', '13 Slavin Ct.', 'Nottingham', 'MD', '21236', '', '678-361-8257', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1885', 'Divorced', '', '', '04/30/16', '[email protected]', 'Shauntaye', 'L', 'Lawson', '', '218863940', '08/12/76', '', '8500 Glen Michael Lane T3', 'Randallstown', 'MD', '21133', '410-922-2634', '443-517-7773', 'n/a');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1887', 'Married', 'White', 'Non Hispanic or Latino', '', '[email protected]', 'Leitha', 'J', 'Nelson', 'Leitha', '465-69-1222', '06/12/1982', 'Female', '423 Florida St', 'Brewton', 'AL', '36426', '', '251-236-5039', '251-867-6287');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1889', 'Single', '', '', '4/6/2016', '[email protected]', 'William', 'S', 'Corder', 'Scott', '249-43-5046', '8/1/1964', 'Male', '407 Palm Court', 'Pensacola', 'Florida', '32505', '', '850-483-7901', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1891', 'Married', 'White', 'Non Hispanic or Latino', '12/2014', '[email protected]', 'Peter', 'B', 'Servais', '', '387-52-5074', '04/30/1952', 'Male', '2616 Barefoot Creek Circle', 'Navarre', 'FL', '32566', '', '608-797-5941', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1893', 'Single', '', '', '5/14/16', '', 'Monique', '', 'Blanding', '', '131647927', '11/29/1980', 'Female', '9737 Clocktower Ln Apt #204', 'Columbia', 'MD', '21046', '', '7165530998', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1895', 'Married', 'White', 'Non Hispanic or Latino', 'Dec 2015', '[email protected]', 'Anthony', 'J', 'DiStasi', 'Tony', '099347097', '10-17-1943', 'Male', '420 Oak Harbour Ln .No 104', 'Destin', 'FL', '32541', '850-582-6166', '850-582-6166', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1897', 'Married', 'Hispanic', '', '12/20/15', '[email protected]', 'Carleen', 'J', 'Gentemann', 'Carleen', '486604627', '7/1/1956', 'Female', '7777 White Sands Blvd', 'Navarre', 'Fl', '32566', '', '3143742066', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1899', 'Married', 'White', 'Non Hispanic or Latino', '1967;2013', '[email protected]', 'Michael', 'L.', 'Sasser', 'Mike', '418-62-3787', '01/29/2016', 'Male', '116 Fairway Dr', 'Brewton', 'AL', '36426', '251-867-2982', '251-363-5536', '251-867-5418');
[/spoiler]
Amount of Records 1093
Price 150
Contact Telegram @TerriblenessBF
Please do not contact if you do not want to purchase
[spoiler]
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('59', 'Husband', 'Jon Perkinson', '417-11-5296', '1/13/71', 'Male', '24411 Gulf Bay rd', 'orange beach', 'al', '36561', '', '251 223-6522', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('61', 'self', 'Anthony Kennon', '424-86-7182', '01/08/1957', 'Male', 'PO Box 3150', 'Orange Beach', 'Alabama', '36561', '251-981-9036', '251-747-8282', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('63', 'Husband', 'Nickolas Todd', '419118239', '12/12/1970', 'Male', '4332 Barclay Place', 'Pace', 'FL', '32571', '8509827730', '8507770122', '');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('65', 'Patient', 'Michele Turner', '293-70-1405', '11-04-1966', 'Female', '5262 Crowson Rd', 'Pensacola', 'FL', '32526', '850-941-2578', '850-449-2396', '850-475-3721');
INSERT INTO `zccf_guardian_information` (`ccf_submission_id`, `relationship_to_patient`, `name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('67', 'self', 'Mary J. Ziemba', '267901134', '08/01/1950', 'Female', '204 Mirabelle Circle', 'Pensacola', 'FL', '32514', '', '850-516-1817', '850-863-6580');
[/spoiler]
Amount of records 1093
Price 150
Sample 2
[spoiler]
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42713', '42709', '45521 state hwy 74, space63', '', 'hemet ', 'CA', '92544', '9513057193', '[email protected]', '', '', '9512699877');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42715', '42711', '', '', '', 'AZ', '', '9282008533', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42717', '42713', '43430 E. Florida Ave. PMB 281', '', 'Hemet', 'CA', '92544', '951 852-0780', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42719', '42715', '1462 burns lane', '', 'san jacinto', 'CA', '92583', '9515302228', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42721', '42717', '1462 burns lane', '', 'san jacinto', 'CA', '92583', '9515302228', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42723', '42719', '20710 Havenhurst Dr. Box 1127', '', 'Nuevo', 'CA', '92567', '951-581-2838', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42725', '42721', '2349 VERSAILLES', '', 'SAN JACINTO', 'CA', '92583', '951-260-3706', '[email protected]', '', '', '951-206-8475');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42727', '42723', '5001 W Florda Ave SP 573', '', 'Hemet', 'CA', '92545', '9513455525', '[email protected]', '', '', '951-652-2811');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42729', '42725', '36274 Chittamwood Ln.', '', 'Murrieta', 'CA', '92562', '(951) 600-5740', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42731', '42727', '30383 lamplighter lane', '', 'menifee', 'CA', '92584', '951 2460153', '[email protected]', '', '', '951 7190869');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42733', '42729', '30383 lamplighter lane', '', 'Menifee', 'CA', '92584', '951 2460153', '[email protected]', '', '', '951 7190869');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42735', '42731', '853 w mayberry ave', '', 'hemet', 'CA', '92543', '9515707007', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42737', '42733', '1299 lucerne dr', '', 'hemet', 'CA', '92543', '9513506085', '[email protected]', '', '', '9513506085');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42739', '42735', '1299 lucerne dr', '', 'hemet', 'CA', '92543', '9513506085', '[email protected]', '', '', '9513506085');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42741', '42737', '39785 KNOLLRIDGE DR.', '', 'TEMECLA', 'CA', '92591', '951-775-8851', '[email protected]', '', '', '951-672-7041');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42743', '42739', '28686', '', 'Menfiee', 'CA', '92584', '951 634-6856', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42745', '42741', '28686 Sunridge Ct.', '', 'Menfiee', 'CA', '92584', '951- 634-6856', '[email protected]', '', '', '');
INSERT INTO `classes_user_billing_address` (`id`, `userID`, `address`, `address2`, `city`, `state`, `zipcode`, `phone`, `email`, `work_phone`, `cell_phone`, `alt_phone`) VALUES ('42747', '42743', '', '', '', 'AZ', '', '9282009070', '[email protected]', '', '', '');
[/spoiler]
Amount of records 21371
Price 200
Sample 3
[spoiler]
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1769', '1767', '1', '4/6/10', '', 'Timothy W. Moman', '419-82-2400', '45', '08/05/1964', '4425 county rd. 26', 'Boaz', 'Al.', '35957', '256-505-1388', 'TSTech Boaz Al 35957', 'assembly worker', '6y 11m', '256-593-9399', '', '', 'none known', '', '', '', '', '', 'Jordan Martin', 'Dr. Angela Clifton', '256-840-4571', 'Boaz ', 'Al', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'Self', 'Same', 'Same', 'Same', 'Same', 'Same', 'BC/BS', '', 'PPA858932901', '04-01-2006', 'Timothy W. Moman', '4425 co. rd. 26', '08-05-1964', '419-82-2400', 'Self', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'no', 'M', 'DIV', 'No', 'no', 'no', 'no', 'Unknown', 'Mid Knuckle and Ring Knuckle on rt. hand want to lock when closed. Ring Knuckle on lt. hand same as rt.', '2010-04-06 11:59:31', '2010-04-06 11:59:31', '0', '0', '1419 summerchase ln.', 'Albertville', 'Al', '35951', '256-293-9787', 'Same', '[email protected]', '14779', '');
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1771', '1769', '1', '4/6/2010', '', 'Donnie Driver', '424922112', '45', '04/18/1964', '1028 Windsor Parkway', 'Moody', 'AL', '35004', '205.640.3703', 'Verizon Wireless / 400 Riverhills Business Park Suite 445 Birmingham, AL 35242', 'Analyst', '5 yrs', '205.994.5223', 'Sherry Driver', '', 'None', '09/17/1960', '417989213', 'Quality Business Solutions', '205.640.3703', 'Owner', 'Heather Driver (Daughter)', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', '', 'Donnie Driver', '1028 Windsor Parkway ', 'Moody', 'AL ', '35004', '205.640.3703', 'BCBS', 'PO BOX 37010 Louisville, KY 40233-7010', 'EZVAN2442383', '01/01/2010', 'Donnie Driver', '1028 Windsor Parkway Moody, AL 35004', '04/18/1964', '424922112', 'Patient', '', '', '', '', '', '', '', '', '', '3/24/2010', '', '', '', '', '', 'no', 'M', 'M', 'no', 'no', 'no', 'no', 'Dog jumped on elbow while arm was stretched out', 'Elbow was hyperextended', '2010-04-06 13:49:36', '2010-04-06 13:49:36', '0', '0', '112 Little Creek Cirle', 'Chelsea', 'AL', '35043', '205.678.7437', 'Patient', '[email protected]', '003330004', '');
INSERT INTO `patient_information` (`id`, `submissionID`, `facilityID`, `date`, `when`, `patient_name`, `ssn`, `age`, `dob`, `address`, `city`, `state`, `zipcode`, `home_phone`, `eschool_address`, `current_job`, `num_employed`, `business_phone`, `spouse_name`, `spouse_address`, `spouse_drug_allergies`, `spouse_dob`, `spouse_ssn`, `spouse_employer`, `spouse_phone`, `spouse_current_job`, `outside_contact`, `ref_name`, `ref_phone`, `ref_city`, `ref_state`, `father_name`, `father_address`, `father_city`, `father_state`, `father_zipcode`, `father_phone`, `mother_name`, `mother_address`, `mother_city`, `mother_state`, `mother_zipcode`, `mother_phone`, `father_dob`, `mother_dob`, `father_ssn`, `mother_ssn`, `father_employer`, `mother_employer`, `father_oc`, `father_business_phone`, `mother_business_phone`, `mother_oc`, `employer_address`, `employer_city`, `employer_state`, `employer_zipcode`, `resp_payment`, `resp_address`, `resp_city`, `resp_state`, `resp_zipcode`, `resp_home_phone`, `ins_name`, `ins_address`, `policy_num`, `policy_eff`, `ph_name`, `ph_address`, `ph_dob`, `ph_ssn`, `ph_rel`, `ins_name2`, `ins_address2`, `policy_num2`, `policy_eff2`, `ph_name2`, `ph_address2`, `ph_dob2`, `ph_ssn2`, `ph_rel2`, `injury_date`, `xray_date`, `xray_loc`, `signed1`, `signed2`, `signed3`, `doctor_past`, `sex`, `mstat`, `job_injury`, `auto_injury`, `attorney_injury`, `xray_injury`, `injury_how`, `injury_taken`, `last_modified`, `created`, `archived`, `deleted`, `oc_address`, `oc_city`, `oc_state`, `oc_zipcode`, `oc_home_phone`, `resp_patient`, `patient_email`, `group_num1`, `group_num2`) VALUES ('1773', '1771', '1', '04/06/2010', '', 'Austin Hardy', '417513318', '10', '11/17/1999', '5413 Saddle Ridge Ln', 'Pinson', 'Al', '35126', '205-680-9192', 'Kermit Johnson Elementary, Pinson , Al', 'Student', 'N/A', 'N/A', 'N/A', '', '', '', '', '', '', '', '', '', '', '', '', 'Bryan Hardy', '5413 Saddle Ridge Ln.', 'Pinson', 'Al', '35126', '205-680-9192', 'Rhonda Hardy', '5413 Saddle Ridge Ln', 'Pinson', 'Al.', '35126', '205-680-9192', '11/14/1963', '11/05/1969', '422863305', '422987642', 'UAB Hospital', 'ENT Assoc of al', 'Anesthesia Tech', '934-3833', '591-8260', 'Medical ass\'t', '6th Ave So.', 'B\'ham', 'Al', '35294', 'Bryan Hardy', '5413 Saddle Ridge Ln', 'Pinson', 'Al', '35126', '680-9192', 'Viva', 'P.O. Box 55926', '11016774', '01/01/2003', 'Bryan Hardy', '5413 Saddle Ridge Ln', '11/14/1963', '422863305', 'father', '', '', '', '', '', '',
[/spoiler]
Amount of Records 1503
Price
150
Sample 4
[spoiler]
NSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1877', 'Married', 'White', 'Non Hispanic or Latino', '', '[email protected]', 'Binnie', 'A', 'Hughes', 'Binnie', '265-66-7495', '2-1-1943', '', '4040 Schaag Rd', 'Cantonment', 'Fl', '32533', '850-587-2107', '850-512-7504', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1879', '', 'White', 'Non Hispanic or Latino', 'n/a', '[email protected]', 'Bobby', 'J', 'Windsor', 'Bob', '419-48-3519', '6/19/40', 'Male', '671 lakeview drive', 'DFS', 'FL', '32433', '850-892-2690', '850-585-0596', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1881', 'Married', 'White', 'Non Hispanic or Latino', '1999', '[email protected]', 'Richard', 'G', 'DaVico', '', '565-51-4153', '3-11-1963', 'Male', '1513 Hunter\'s Creek Drive', 'Cantonment', 'FL', '32533', '(850)9688-1013', '(850)512-4422', '(850)937-4345');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1883', 'Single', '', '', '04\\03\\16', '[email protected]', 'Martina', 'L', 'Woodard', 'Martina', '217-68-4875', '01\\03\\58', 'Female', '13 Slavin Ct.', 'Nottingham', 'MD', '21236', '', '678-361-8257', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1885', 'Divorced', '', '', '04/30/16', '[email protected]', 'Shauntaye', 'L', 'Lawson', '', '218863940', '08/12/76', '', '8500 Glen Michael Lane T3', 'Randallstown', 'MD', '21133', '410-922-2634', '443-517-7773', 'n/a');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1887', 'Married', 'White', 'Non Hispanic or Latino', '', '[email protected]', 'Leitha', 'J', 'Nelson', 'Leitha', '465-69-1222', '06/12/1982', 'Female', '423 Florida St', 'Brewton', 'AL', '36426', '', '251-236-5039', '251-867-6287');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1889', 'Single', '', '', '4/6/2016', '[email protected]', 'William', 'S', 'Corder', 'Scott', '249-43-5046', '8/1/1964', 'Male', '407 Palm Court', 'Pensacola', 'Florida', '32505', '', '850-483-7901', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1891', 'Married', 'White', 'Non Hispanic or Latino', '12/2014', '[email protected]', 'Peter', 'B', 'Servais', '', '387-52-5074', '04/30/1952', 'Male', '2616 Barefoot Creek Circle', 'Navarre', 'FL', '32566', '', '608-797-5941', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1893', 'Single', '', '', '5/14/16', '', 'Monique', '', 'Blanding', '', '131647927', '11/29/1980', 'Female', '9737 Clocktower Ln Apt #204', 'Columbia', 'MD', '21046', '', '7165530998', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1895', 'Married', 'White', 'Non Hispanic or Latino', 'Dec 2015', '[email protected]', 'Anthony', 'J', 'DiStasi', 'Tony', '099347097', '10-17-1943', 'Male', '420 Oak Harbour Ln .No 104', 'Destin', 'FL', '32541', '850-582-6166', '850-582-6166', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1897', 'Married', 'Hispanic', '', '12/20/15', '[email protected]', 'Carleen', 'J', 'Gentemann', 'Carleen', '486604627', '7/1/1956', 'Female', '7777 White Sands Blvd', 'Navarre', 'Fl', '32566', '', '3143742066', '');
INSERT INTO `zccf_patient_demographics` (`ccf_submission_id`, `marital_status`, `race`, `ethnicity`, `injury_date`, `email_address`, `first_name`, `middle_initial`, `last_name`, `preferred_name`, `ssn`, `dob`, `sex`, `address_street`, `address_city`, `address_state`, `address_zip`, `phone_home`, `phone_cell`, `phone_work`) VALUES ('1899', 'Married', 'White', 'Non Hispanic or Latino', '1967;2013', '[email protected]', 'Michael', 'L.', 'Sasser', 'Mike', '418-62-3787', '01/29/2016', 'Male', '116 Fairway Dr', 'Brewton', 'AL', '36426', '251-867-2982', '251-363-5536', '251-867-5418');
[/spoiler]
Amount of Records 1093
Price 150
Contact Telegram @TerriblenessBF
Please do not contact if you do not want to purchase