CAL-LUC-66

Code
CAL-LUC-66
Mercy ID
V-00631-01
Encounter Date
05/21/2002
Last
Calmo mendoza
First
Lucia
DOB
03/30/1966
County
Cherokee
Street
18 Lee St.
City
Canton
State
GA
Zip
30411-
Home
(678) 493-5875
Cell
(678) 704-9137
Family Status
Two parent family 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
No
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