COR-ANA-72

Code
COR-ANA-72
Mercy ID
V-00859-01
Encounter Date
03/06/2002
Last
Coria
First
Ana
DOB
07/25/1972
County
Forsyth
Street
2560 Bufford Dam Rd.
City
Cumming
State
GA
Zip
30041-
Home
(770) 888-5659
Cell
(678) 755-6339
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high 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
YES
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