JUA-BLA-01

Code
JUA-BLA-01
Mercy ID
V-00495-01
Encounter Date
05/02/2001
Last
Juarez
First
Blanca
DOB
05/02/1978
County
Dekalb
Street
6800 peachtree industrial apt d-9
City
Doraville
State
GA
Zip
30360-
Home
(404) 218-2916
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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
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
S. Aviña