DOR-PAT-77

Code
DOR-PAT-77
Mercy ID
V-00842-01
Encounter Date
02/12/2002
Last
Donato
First
Patricia
DOB
05/18/1977
County
Not given
Street
15 Mayfair Dr.
City
Covignton
State
GA
Zip
30016-
Home
(678) 342-9285
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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