SAR-PAT-72

Code
SAR-PAT-72
Mercy ID
V-00893-01
Encounter Date
04/02/2002
Last
Sarmiento
First
Patricia
DOB
09/18/1972
County
Cobb
Street
1119 Medlin St.
City
Smyrna
State
GA
Zip
30080-
Home
(678) 627-0535
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
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. Perez
Data Entry
K. Aleman