CAN-DAI-98
- Code
- CAN-DAI-98
- Mercy ID
- V-00868-11
- Encounter Date
- 03/20/2002
- Last
- Canchola
- First
- Daisy
- DOB
- 03/20/1998
- County
- Fulton
- Street
- 1460 North Cliff Valley Way
- City
- Atlanta
- State
- GA
Parents Information
| Name | DOB | COB | |
|---|---|---|---|
| Mother | Maria Bernal | 10/31/1975 | Mexico |
| Father | Raul Canchola | N/A | EEUU |
| Step Parent | N/A | N/A | N/A |
- Driver
- No
- Relative
- No
- Stranger
- No
- Lives With
- Parents
- Name of School
- N/A
- Grade
- N/A
- Who Can't Pickup the Child
- Authoritation Parent
- No
- Authoritation Child
- No
- DOY PERMISO
- No
- Limitado Educativo
- No
- Limitado Impresos
- No
- Limitado Caminar Latino
- No
NOTES
Media
NO DOY PERMISO
- Intake
- Y. Garcia
- Data Entry
- K. Aleman