WIL-ELE-65

Code
WIL-ELE-65
Mercy ID
V-00493-01
Encounter Date
02/21/2002
Last
Wilson
First
Elena
DOB
05/14/1965
County
Gwinnett
Street
5769 William Rd.
City
Norcross
State
GA
Zip
30093-
Home
(770) 806-1497
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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
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
K. Aleman