ALB-IRM-78

Code
ALB-IRM-78
Mercy ID
V-00857-01
Encounter Date
03/08/2002
Last
Alberto
First
Irma
DOB
12/23/1978
County
Gwinnett
Street
2306 Noble Forest Drive
City
Norcross
State
GA
Zip
30092-
Home
(770) 449-6298
Cell
(404) 399-1526
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
YES
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
K. Aleman