GAI-KAT-78

Code
GAI-KAT-78
Mercy ID
V-00766-01
Encounter Date
12/04/2001
Last
Gaitan
First
Katherine
DOB
09/30/1978
County
Fulton
Street
6942 Spring Wood Dr.
City
Douglasville
State
GA
Zip
30328-
Home
(678) 838-9541
Family Status
Two parent family w/children
COB
USA
Gender
Female
Housing
Doubling Up
Education Level
some high school
Home Owner
YES

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