VAL-ANA-67

Code
VAL-ANA-67
Mercy ID
V-01029-01
Encounter Date
11/05/2002
Last
Valencia
First
Ana lucia
DOB
03/25/1967
County
Other
Street
702 Bell Court Parkway
City
Roswell
State
GA
Zip
30076-
Home
(687) 352-1870
Cell
(770) 617-9857
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
some high school
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
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