BAR-EVA-65

Code
BAR-EVA-65
Mercy ID
V-00752-01
Encounter Date
11/13/2001
Last
Barajas
First
Eva
DOB
06/20/1965
County
Dekalb
Street
2232 Plaster Rd. Apt. A
City
Chamblee
State
GA
Zip
00000-0000
Home
(404) 325-5920
Family Status
Single parent w/children
COB
Mexico
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
K. Aleman