PIÑ-LAU-71

Code
PIÑ-LAU-71
Mercy ID
V-00453-01
Encounter Date
06/27/2001
Last
Piñon
First
Laura
DOB
04/14/1970
County
Gwinnett
Street
625 Field Good Lane
City
Alpharetta
State
GA
Zip
00000-0000
Home
(000) 000-0000
Cell
(000) 000-0000
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Some College
Home Owner
No

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
K. Aleman