RUI-FAN-67

Code
RUI-FAN-67
Mercy ID
V-00534-01
Encounter Date
05/22/2001
Last
Ruiz
First
Fanny
DOB
03/28/1967
County
Cobb
Street
3122 North Place Way
City
Smyrna
State
GA
Zip
30080-
Home
(770) 438-8620
Family Status
Two parent family w/children
COB
Venezuela
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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
K. Aleman