FIG-ISA-57

Code
FIG-ISA-57
Mercy ID
V-00757-01
Encounter Date
12/05/2001
Last
Figueroa
First
Isabel
DOB
07/08/1957
County
Dekalb
Street
5315 Kemper Place
City
Stone mountain
State
GA
Zip
30088-
Home
(770) 498-0934
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
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. Manzo
Data Entry
K. Aleman