DEA-NOR-69

Code
DEA-NOR-69
Mercy ID
V-00455-01
Encounter Date
03/22/2001
Last
De avila
First
Nora
DOB
02/01/1969
County
Cobb
Street
410 Mcarhtur Dr.
City
Marietta
State
GA
Zip
30060-
Home
(678) 571-0089
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
Home Owner
YES

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
YES
Relative
No
Stranger
No
NOTES
Signed consent form and promesa before the fire
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. Perez
Data Entry
D. Gomez