CRU-JAS-76

Code
CRU-JAS-76
Mercy ID
V-00556-01
Encounter Date
05/04/2001
Last
Cruz
First
Jasmin
DOB
08/21/1976
County
Dekalb
Street
1403 North Cliff Valley Way Apt. C
City
Atlanta
State
GA
Zip
30319-
Home
(404) 320-0490
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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. Manzo
Data Entry
K. Aleman