Beruflich Dokumente
Kultur Dokumente
JS 44 (Rev. 12/12)
The JS 44 civil cover sheet and the information contained herein .neither replace nor supplement the fihng and service of pl~adings or other papers as required by law, except as
provided by local rules of court. This form, approved by the Jud1c1al Conference of the Umted States m September 1974, 1s reqmred for the use of the Clerk of Court for the
purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXF PAGE OF THIS FORM.)
DEFENDANTS
I. (a) PLAINTIFFS
Allen, Halimah
Dekalb County
_,_P,_,h"'ila,._d,,_e=lp~h"'ia"-----
ederal Question
(US. Government Not a Party)
Plaintiff
0 2
0 4
U.S. Government
Defendant
Diversity
(Indicate Citizenship of Parties in Item Ill)
I.
0
0
0
0
0
0
PERSONAL INJURY
0 310 Ai1plane
0 315 Ai1plane Product
Liability
0 320 Assault, Libel &
Slander
0 330 Federal Employers'
Liability
0 340 Mruine
0 345 Marine Product
Liability
0 350 Motor Vehicle
0 355 Motor Vehicle
Product Liability
0 360 Other Personal
Injury
0 362 Personal Injwy Medical Maloractice
REJfLPROPERTY .?dt;'. ~CIVIL RIGHTS '' Y
210 Land Condemnation
\
Other Civil lbghts
220 Foreclosure
I Voting
2 Employment
230 Rent Lease & Ejectment
240 Torts to Land
0 443 Housing/
245 Tort Product Liability
Accommodations
290 All Other Real Property
0 445 Amer. w/Disabilities Employment
0 446 Amer. w/Disabilities Other
0 448 Education
110 Insurance
120 Mruine
130 Miller Act
140 Negotiable lnsllurnent
150 Recovery of Overpayment
& Enforcement of Judgment
151 Medicare Act
152 Recovery of Defaulted
Student Loans
(Excludes Veterans)
153 Recovery of Overpayment
of Veteran's Benefits
160 Stockholders' Suits
190 Other Contract
195 Contract Product Liability
196 Franchise
ilo
1GIN
)!!( 1
.:. w
0 2
0 5
Citizen or Subject of a
Forei Counll
0 3
Foreign Nation
0 6
PERSONAL INJURY
0 365 Personal Injury Product Liability
0 367 Health Care/
Phannaceutical
Personal Injwy
Product Liability
0 368 Asbestos Personal
Injury Product
Liability
PERSONAL PROPERTY
0 370 Other Fraud
0 371 Truth in Lending
0 380 Other Personal
Property Damage
0 385 Property Damage
Product Liability
.DEF
0 690 Other
28
use 157
"ROPERTYifilGHTS:
....
0 &20 Copyrights
0 830Patent
0 S40 Trademark
V%,,
'
?;
0 720 Labor/Management
0
0
0
Relations
740 Railway Labor Act
751 Famity and Medical
Leave Act
790 Other Labor Litigation
791 Employee Retirement
Income Secwity Act
.O'FH.ERSTAlllUTES'';ii .. I
lfSOCIALSECURITYi'
0 86 i HIA ( 1395ff)
0 862 Black Lung (923)
0 863 DIWC/DIWW (405(g))
0 864 SSID Title XVI
0 865 RSI (405(g))
ArifiFEDERAii"fAX:SUJTS%!'
+PRISONER PETI'l'IONSJ!: 0
0 S70 Taxes (U.S. Plaintiff
Habeas Corpus:
0 463 Alien Detainee
or Defendant)
0 871 IRS-Third Party
0 510 Motions to Vacate
26 use 7609
Sentence
0 530 General
0 535 Death Penalty
""""" <1:)Ml\'II6RATION4ffe...'.Eii
Other:
0 462 Naturalization Application
0 540 Mandamus & Other
0 465 Other Immigration
Actions
0 550 Civil ibgb.ts
0 5 55 Prison Condition
0 560 Civil Detainee Conditions of
Confinement
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
o.,
(Pk""" "X".
B~ Om,I
riginal
0 2 Removed from
roceeding
State Court
Remanded from
Appellate Court
0 4 Reinstated or
Reopened
0 5 Transferred from
Another District
06 Multidistrict
Litigation
(specifj;)
"'-..)
Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
'
Defendants violated Plaintiff Constitutional rights to be free from unl!lwful search and seizyre_and excessive force.
VII. REQUESTED IN
0
COMPLAINT:
VIII. RELATED CASE(S)
IFANY
RECEIPT#
AMOUNT
""
DEMAND$
'
JURY DE
~
MAG.JUDGE
Does this civil action involve a nongovernmental corporate party with any parent corporation and any publicly held corporation owning 10% r
(Attach two copies of the Disclosure Statement Form in accordance with Fed.R.Civ.P. 7.l(a))
YesD
re of its stock?
YesD
Case Number: _ _ _ _ _ _ _ _ _ _ _ _ Judge _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date T e r m i n a t e d : / - - - - - - - - - - - - - - - - - - - - Civil cases are deemed related when yes is answered to any of the following questions:
i
I
I. Is this case related to property included in an earlier numbered suit pending or within one year previously termin~ted action in this court?
I
YesD
No~
2. Does this case involve the same issue of fact or grow out of the same transaction as a prior suit pending or withi~ one year previously terminated
I
action in this court?
/
YesD
Nol:B"""
3. Does this case involve the validity or infringement of a patent already in suit or any earlier numbered case pendi1g or within one year previouJJy
terminated action in this court?
YesD
No!JY"'
4. Is this case a second or successive habeas corpus, social security appeal, or pro se civil rights case filed by the sajne individual?
YesD
CNIL: (Place
A.
No~
B.
DiversityiJurisdiction Cases:
1.
I
1. o Insurance Contract and Other Contracts
2.
FELA
3.
3. o Assailt, Defamation
I
4. o Antitrust
5.
5.
6.
7.
8.
Prod~cts Liability
Prod~cts Liability -
9.
Patent
11.
Asbestos
(Plea~e specify)
(Please s p e c i f y ) - - - - - - - - - - - - - - - - - - 1
ARBITRATION CERTIFICATION
(Check Appropriate Category)
~ ~U..
, counsel of record do hereby certify:
ErPUrSant to Local Civil Rule 53.2, Section 3(c)(2), that to the best of my knowledge and belief, the damages recoverable in this civil action case exceed the sum of
$1~.,9.POOO exclusive of interest and costs;
I,
D:dfo~:t;;z7-'"i""oogh<
T- /
:/~ ~
umlZC/
~~-U.w
Att~cym
NOTE: A trial d novo will be a trial by jury only if there has been complia~ce with F.R.C.P. 38.
I
I certify that, to my knowledge, the within case is not related to any case now pending or within one year pre~iously terminated action in this court
except as noted above.
I
DATE
nh,r;/11
T
2a']_]'l
Attorney I.D.#
~1334
NO.
( )
(b) Social Security - Cases requesting review of a decision of the Secretary of Health
and Human Services denying plaintiff Social Security Benefits. I
( )
(c) Arbitration - Cases required to be designated for arbitration under Local Civil Rule 53.2.
( )
(d) Asbestos - Cases involving claims for personal injury or prope~ damage from
exposure to asbestos.
1
(e) Special Management- Cases that do not fall into tracks (a) throJgh (d) that are
commonly referred to as complex and that need special or intens~ management by
the court. (See reverse side of this form for a detailed explanati~n of special
i
management cases.)
(f) Standard Management - Cases that do not fall into any one of th~ other tracks.
#JL.~ i Jtl~~
nff i
Dat(
J:L.5 - 235-ZJ.57
Telephone
Attorney for
;afow@.JU~.e.o"1.
/(,(
FAX Number
E-Mail Address
DEC 3 0 20M}
\~\THE
Halimah Allen
3603 Mecklinburg Place,
Decatur, GA 30032
Plaintiff,
CIVIL ACTION
14
CASE NO.
v.
University of Pennsylvania
Police Department
Franklin Building
3451 Walnut Street Suite 421
Philadelphia, PA 19104
and
University of Pennsylvania
Police Department
133 S. 36th Street
Philadelphia, PA 19104
and
Police Officer Julia Umbrell
(individually and in her official capacity)
Franklin Building
3451 Walnut Street Suite 421
Philadelphia, PA 19104
and
Police Officer John Doe
(individually and in his official capacity)
Franklin Building
3451 Walnut Street Suite 421
Philadelphia, PA 19104
Defendants.
Plaintiff HALIMAH ALLEN (hereinafter "Plaintiff'), by and through her attorneys, MFI
Law Group, PLLC, hereby brings this action under 42 U.S.C. 1983 to redress her civil and
legal rights, and alleges as follows:
PRELIMINARY STATEMENT
1. This is a civil rights action in which Plaintiff seeks relief for Defendants' violations of her
rights secured by the Civil Rights Act of 1871, 42 U.S.C. 1983, by the United States
Constitution, including its First, Fourth and Fourteenth Amendments, and by the laws and
Constitution of the State of Pennsylvania. Plaintiff seeks compensatory and punitive
damages, an awards of costs, interest and attorney's fees, and such other and further relief as
this Court deems just and proper.
PARTIES
4. At all times relevant to this action, Plaintiff is a resident of Fulton C:ounty, Georgia.
5. Defendant is and was at all times relevant herein a municipal entity created and authorized
under the laws of the State of Pennsylvania. It is authorized by law to maintain a police
department which acts as its agent in the area of law
enforc~ment
ultimately responsible. Defendant assumes the risks incidental to ~he maintenance of a police
force and the employment of police officers. Defendant was at all times relevant herein the
public employer of Defendant Police Officer Julia Umbrell ("Officer Umbrell") and
Defendant Police Officer John Doe ("Officer Doe").
6. Defendant Officer Umbrell is and was at all times relevant herein duly appointed and acting
officer, servant, employee, and agent of the University of Pennsylvania Police Department.
At all times relevant herein, the individual defendant was acting under color of the laws,
statutes, ordinances, regulations, policies, customs and/or usages of the State of Pennsylvania
and the University of Pennsylvania Police Department, in the course and scope of her duties
and functions as an officer.
7. Defendant Officer Doe is and was at all times relevant herein duly appointed and acting
officer, servant, employee, and agent of the University of Pennsylvania Police Department.
At all times relevant herein, the individual defendant was acting under color of the laws,
statutes, ordinances, regulations, policies, customs and/or usages of the State of Pennsylvania
and the University of Pennsylvania Police Department, in the cou,rse and scope of his duties
and functions as an officer.
8. By the conduct, acts, and omissions complained of herein, Defendant Officers Umbrell and
Doe violated clearly established the constitutional standard under the First, Fourth, and
Fourteenth Amendments to the United States Constitution of which a reasonable police
officer under the circumstances would have known.
NOTICE OF CLAIM
9. Plaintiff timely filed a Notice of Claim with the University of Pennsylvania Police
Department setting forth the facts underlying Plaintiffs claim against Defendant and Officer
Umbrell.
10. To date, Plaintiff has not received an answer nor has compnsation been offered by
Defendant in response to this claim.
FACTS
11. On or about July 27, 2013, Plaintiff was a passenger in a vehicle located near the 3100 block
of Market Street.
12. Plaintiff was asleep in the vehicle with another passenger awaiting the driver to take her to
her residence.
13. Unbeknownst to Plaintiff, the driver of the vehicle flagged down Officer Umbrell to request
assistance in getting Plaintiff to her destination since he was too inebriated to drive her home.
14. Plaintiff was suddenly awakened when Officer Umbrell reached in the vehicle and dragged
her out of the passenger side.
15. Officer Umbrell then slammed Plaintiff against the side of the vehicle, began to grab
Plaintiffs neck, and continued to punch her violently.
16. In an effort to protect herself, Plaintiff began to swing back in an attempt to get Officer
Umbrell off of her.
17. However, Officer Umbrell had radioed for back up and upon Officer Doe's arrival Plaintiff
was thrust to the ground. (See Exhibit A - Transcript from Preliminary Hearing, p. 7).
18. Immediately, Officer Doe drew his firearm pointing at Plaintiff.
19. Plaintiffs face was then slammed in to the concrete and Officer Doe shoved his knee directly
in to Plaintiffs spine while handcuffing her.
20. Subsequently, Plaintiff was taken to the 181h Police Precinct located at 5510 Pine Street,
Philadelphia, PA 19143.
21. Upon arrival, the officers noticed the extensive injuries Plaintiff Sustained and immediately
transferred her to Mercy Hospital to obtain emergent medical care for her injuries sustained
during this assault. (See Exhibit B - Mercy Hospital Medical Record).
22. Due to the assault, Plaintiff sustained significant injuries to her
fa~e,
33. As a direct and proximate cause of Defendants' actions and inactjons, Plaintiff suffered and
continues to suffer deprivation of her rights, fear, horror, loss
o~
injuries, and the loss of the enjoyment oflife, all to their great detriment and loss.
34. As a direct and proximate cause of Defendants' actions and inactions, Plaintiff suffered and
was made to undergo great physical pain and horrible mental anguish requiring medical
treatment, as well as loss of earning power and earning potential,i all to her great detriment,
financial detriment and personal loss.
35. Plaintiffs serious injuries were a foreseeable and direct result of t)le actions and inactions of
all Defendants.
36. Defendants' violated Plaintiffs clearly established and well settled federal constitutional
rights, including but not limited to her freedom to assemble, her right to substantive due
process, liberty, personal security, her right to be free from unre11sonable seizures, and her
right to be free from the use of excessive, unreasonable and unjust~fied force.
37. The Defendants have with deliberate indifference, failed to be adequately trained and
supervised concerning the proper provision of medical care to injured suspects, and the
injuries to Plaintiff were caused by, and were foreseeable consequences of such failures.
38. In addition, the Constitutional violations suffered by Plaintiff wer'? the result of the failure to
properly train and supervise the officers with regard to the proper methods of ascertaining
whether a citizen was engaging in possible criminal activity and executing an arrest of the
aforementioned citizen.
COUNT ONE
FOURTH AMENDMENT- UNLAWFUL SEARCH AND SEIZURE,
EXCESSIVE FORCE
Plaintiff v. Defendants, 42 U.S.C. 1983.
40. As a direct and proximate result of Defendants' actions, more pafticularly described above,
Plaintiffs rights protected under the Fourth Amendment to be free from unreasonable search
and seizure and to be free from the use of excessive force were violated and she suffered
grievous bodily injury including but not limited to: nerve damage, facial lacerations, neck
injury, back injury, and shoulder injury.
41. Defendants subjected Plaintiff to these deprivations of rights unreasonably, intentionally,
willfully, maliciously, with deliberate indifference and/or with a reckless disregard for the
natural and probable consequences of their acts, and was done without lawful justification or
reason, and was designed to and did cause specific and serious physical and emotional pain
and suffering in violation of Plaintiffs rights as guaranteed under 42 U.S.C. 1983 and the
Fourth Amendment to the United States Constitution.
42. Plaintiff in this action is a citizen of the United States and all of the individual police officer
Defendants to this claim are persons for purposes of 42 U.S.C. 1983.
43. As a direct and proximate result of the acts and omissions of Defendants, Plaintiff suffered
damages as set forth above and deprivations of her rights
an~
detriment.
44. Solely as a result of Defendants' conduct, Plaintiff suffered
sub~tantial
damages, including
violated and she suffered grievous bodily injury, including but not limited to: nerve damage,
facial lacerations, neck injury, back injury, and shoulder injury.
47. Defendants subjected Plaintiff to these deprivations of rights upreasonably, intentionally,
willfully, maliciously, with deliberate indifference and/or with a; reckless disregard for the
natural and probable consequences of their acts, and was done
wi~hout
lawful justification or
reason, and was designed to and did cause specific and serious physical and emotional pain
and suffering in violation of Plaintiffs rights as guaranteed under 42 U.S.C. 1983 and the
Fourteenth Amendment to the United States Constitution.
48. As a direct and proximate result of the acts and omissions of Defendants, Plaintiff suffered
damages as set forth above and deprivations of her rights an,d liberty interest at great
detriment.
WHEREFORE, Plaintiff demands judgment against Defendants for all available damages,
cos~s
pursuant to 42 U.S.C.
1988.
JURY TRIAL DEMANDED
By:~
VERIFICATION
I, Halimah Allen, hereby verify that I am the Plaintiff in the attached Cpmplaint, and that the
facts set forth herein are true and correct to the best of my knowledge, ~nformation and belief. I
understand that false statements made herein are subject to the penaltie~ of the 18 PA C.S.
'
Halimah Allen
EXHIBIT "A"
i
L.
... (),,:';
"""'
, r .
..
Halimah Allen
Page 1
[1]
[2]
[31
Page 2
[1]
[2J
[4)
[:]
[5]
[6j
[5]
[G] COMMONWEAL TH
f7l VS.
: MC-5!-CR-0029142-2013
[o] HALJMAH ALLEN
[!l]
ft1]
[10]
{iO]
PRELIMINARY HEARING
AUGUST 12, 2013
P2J
[7]
fB]
[11 J
APPEARANCES:
[3)
[111
1121
[1:3]
{14J
[15]
pr;]
[15J
[16}
f17l
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[ 17]
l1ii]
[HJ]
(HJ
[:'DJ
BEFORE:
['.:1j
[20]
[21]
[22]
[22]
[2'.l]
[23]
~I
125]
[25]
Page3
f-N-D-E-X
[1]
Page 4
[1]
l<'l
[2]
[3]
[3]
f"! WITNESS
[5}
{4]
bl
5 8
{GI
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[I']
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{(lJ
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EXHIBJTS
[11]
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[13JNO.
[12]
DESCRIPTION
PAGE
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[14J
[14J
[1~]
[18]
[16!
[F]
~17]
[181
[i8]
[19J
['.!2j
[23]
[24]
[2~]
1 (page 14)
51CR00291'422013
Halimah Allen
UMBRELL - DIRECT
[1]
[2)
[3J
BY MR. FRITZE:
[SJ
v-
tf/
[16]
Page 6
[1]
BY MR. FRITZE:
she
Page 8
Page7
(10]
(12]
[ 1J struck
Did yo~
[14) incident?
a.
(2]
[3]
questions.
[4]
[5]
[6]
[7]
[8]
[9]
[11]
[13]
[14]
[15)
(16]
[17]
[18]
[HJ]
(20]
UMBRELL - CROSS
[21]
(22]
2 (page 5 8)
Page 9
[1) A.
[1]
[2] of two.
f3]
[6]
[7]
[81
l9J BY MR.
CR!C'.iT':':'~:
Page 12
Page 11
{1] Q.
3 (page 9 -12)
.....
---. --------
51CR00291422013
Halimah Allen
[1JA. Yes.
[2] Q. You said that she had spit at who we'll call the
[3] complainant, the person who came and got you?
(4] A. Yes, the reporting person, yes.
[5] Q. And you said that she also spit in the direction of
[6] the other officer but it did not -[7] A. Right.
[8J Q. So no spit landed on the officer?
[9) A. No, he stepped out of the way.
[10] Q. Was she taken to the hospital?
[11 J A. I believe she was.
[12] Q. You yourself you said that you sustained -- you had
[13) an abrasion on your arm?
[14] A. Yes.
[15] Q. You did not go to the hospital?
[1GJA. No.
f17J Q. You did not miss any time from work?
[18JA. No.
[19]
MR. CRICHTON: I have no further questions.
[20)
MR. FRITZE: Nothing further, Your Honor.
[21]
THE COURT: I have a question.
[22]
What was she being investigated for or in
(23]
custody for and did you ever call Philadelphia
{24]
Police?
[251
THE WITNESS: Did I call Philadelphia
Page 14
(1]
[2]
Po!ice?
T;-;~
[3]
(4]
[5)
[6]
[7]
[8)
[9]
[10]
[11]
(12]
[13]
My seccO'
(14]
never ca:.1c:t.
[15J
[16)
[17]
[18]
[19]
[20)
[21]
[22}
[23}
[24]
[25]
Page 15
[1)
Page 16
[1]
[2]
[2]
[3]
[3]
[4)
[4]
{5]
[6!
[7)
[8]
[5]
(6]
[7]
[8]
[9]
[9]
[10]
(10]
[11]
(ARGUMENT)
[12]
[12]
[13]
[141
[15]
[16)
[17]
[18]
[19]
[20]
[211
[22]
(23]
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{17]
[18)
[19J
[20]
[21]
(22!
[23]
[24j
[25]
cf
4 (page 13 -16)
5ICR0029'4.22013
Halimah Allen
Page 18
Page 17
[1]
[2]
[3]
[4]
[5]
(6]
[7]
[8]
[91
[101
[11 J
[12)
[13]
[14]
[15]
[16]
[17]
[18]
[19)
[20J
(21]
[22]
[23]
[24]
[25]
[1J
[2]
[3]
[4]
[5]
[6]
[7)
[8]
[9]
[10]
[11]
[12]
(13]
[14]
erJ<::agh
[15]
[16]
be in the ,-.2:-=
~
beca.':se :--
'
(171
F'Jc~b:c C<:'.i.:S' .)
0
(18)
[19)
[20]
[21]
[22]
[23]
[24]
[25]
Page 19
[1)
[2)
[3]
(4]
[5]
j6]
(7]
[8]
[9]
[10]
[11]
[12]
[13]
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{15]
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(17]
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[19]
[20]
!21]
[22]
[23)
[24)
[25]
Page 20
[12J
[13]
[14J
[18]
[19]
here.
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[15]
[16)
[17)
[20]
[21]
[22]
[23)
[24)
[25)
Th2.~
0\17::\.
5 (page 17 - 20)
Halimah All~n-
Page 21
[1]
(2]
[SJ
[4]
(5]
[6)
[7]
[8]
(9]
(10]
[11]
[12]
[13]
[14]
{15J
[16]
(171
(18]
(19]
[20]
(21]
(22]
[23]
(24]
[25]
resisting.
Your Honor, she was charged with disorderly
conduct. She was also charged with recklessly
endangering another person. And I would say
that kind of flows into it.
THE COURT: You got to leapfrog here from
the initial charge --1'11 take you through it.
The initial charge an investigation. You have
all of this going on and then absolutely nothing
and everything is pertinent to the officer only
and nothing about the investigation or nothing.
MR. FRITZE: Your Honor, for a vehicle you
can't charge trespass on a vehicle. We had this
last week with Judge Simmons.
THE COURT: Well, what could she have
charged then?
MR. FRITZE: You could have charged
attempted theft - no, you can't even charge
attempted theft because she has to have the
intent to go in there and take the vehicle. We
don't know what she was doing but she was in
someone's property she was not suppose to be in.
YOU can charge criminal trespass if you
live in a motor home. There has to be some sort
of --
Page 22
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
(10]
[11]
[12]
[13]
[14]
(15]
[16]
[17]
[18]
(19]
[20]
[21]
[22]
[23]
[24)
[25)
Page23
[1)
[2)
[3]
[4]
[5)
[6)
[7]
[8]
(HEARING CONCLUDED)
[9]
Page 24
[1]
C-E-F~-;:'-I-f-I-C-A-T-E
[2]
(3]
(4]
[5]
[6]
[7]
[8]
SAME.
[9]
[10]
(10]
[11]
[11]
GAR~
(12]
[12]
CO::JRT REPORTER
[13]
[13]
[14]
[14]
[15]
[15]
[16]
[16]
PA5TER
[19)
(19]
[20]
[20]
[21]
[21)
[22}
[22]
[23]
[231
[24f
[24)
[25]
(25]
[171
[17]
[18]
[18]
6 (page 21 24)
EXHIBIT "B"
MAR/25/ZJ'.4/TUE C2:41 PM
PAGE 3
Allen, Halim.ah
MERCY PHILADELPHIA
PRIMARY
- - - - - - - - - - - - - - - - - - - l:'lltlt!ttlDP-lll
T:98..4 (Oral)
Paln:S (Ai;hy)
ADMIK
PATIF.NT nATA CHANGF.: Primary l'\uri;e changed from (none) to Latasha Womacl:,RX
~OJ)Jll~
(mo36)
(OU':
OF 17
Document
P. 23
C'.3/:J27
YAX1 Mo.Filed 12/30/14 Page 23 of
MAR/25/28'.4/TUE Case
02:41 2:14-cv-07334-TJS
PM
PAGE 4
Allen. a.nmah
MERCY PHILADELPIDA
PRIMARY
Patic~t S11eet: 61 W SHA RPNAC:K ST
Patient Street 2:
KNOWN ALl,F.RGJF,S
No Kn.own Drug Alfergies
hon~
r~gc:
2 ofS
Docomcntliou n{patient ~.1.. chmg=pro\<lder <anlacl dflJcllimc. PatiCJ>I can::>DocumCJ>tali~n:Tune lemps iruoy 001 n:Qi:.<:1 lin:iec:= prv>ided.
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OF 17