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HOME ADDRESSES MEDICAL AiD RD.S wRiyerCW T NAMES Co. Hospitol, Riverside, Cal.Riverside Co. Hospi Unknown No""other driver" Luther CURLEY FTR DAR RPRON NURDAESTAM ASC CAUOFACCASDXT PPRAL CP RELATE CONVERSATION AND NAMES AND ADDRESSE CI CTHCRS ARNG SUCH STATCMENTS L. W. GILMAN 4401 Hazelbrook Long Beach, Calif. 90800 MAKE :.. None : OPERATOR'S STATE PERMIT NUMBERE VEHICLE LICENSE NUMCER No other vehicle involved E GROPERTYE OPERATED BY OWNED BY ADDRESSEom OWNER'S ADDRESS (usines PARTS OF VEHICLE DAMAGED DC 4401 Hazelbrook L. W. GILMAN Long Beach, Calif. 90800 9 WITNESSES OTHER PROPERTY DAMAGED (Dcscriba Hiohway. BADGE NO. PRECINCT OR HQS. Unknown X. INDICATEONTHE DIAGRAMSELOW WHAT HAPPENEO C b6 .Number Federal vehicle es 1~other vehicle a 2additional vehiele YOUR VEHICLE OTHER VEHICLE b7C DIRECTION OF TRAVEL (Exampl S.Give CTON OF TRAVEL South on freeway SIDE OF STREET OR HIGHWAY SIDE OF STREET OR HIGHWAY Right.side Riverside Freeway APPROXIATE SPEED pr our ! APPROXIMATE SPEED (ilcs per hour 60~65 est CCNITION OF KOADWAYI or dryc Dry WEATHR Cir.fo.ranow.cl. Clear Concrete. OTHER INFORMATIONInd Nonc