ROS-MAR-79

Code
ROS-MAR-79
Mercy ID
V-00996-01
Encounter Date
08/20/2002
Last
Rosa
First
Maria
DOB
09/14/1979
County
Fulton
Street
11208 Lexington Dr.
City
Alpharetta
State
GA
Zip
30004-
Home
(678) 458-9095
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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