CIR-CAR-78

Code
CIR-CAR-78
Mercy ID
V-00798-02
Encounter Date
01/15/2002
Last
Ciru
First
Carlos
DOB
04/26/1978
County
Gwinnett
Street
1184 Valley Circle Apt. 5
City
Norcross
State
GA
Zip
30093-
Home
(770) 654-2382
Cell
(770) 923-6920
Family Status
Two parent family w/children
COB
Honduras
Gender
Male
Housing
Doubling Up
Education Level
Some College
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
F. Perez
Data Entry
K. Aleman