FIZ-MAR-58

Code
FIZ-MAR-58
Mercy ID
V-01050-01
Encounter Date
12/10/2002
Last
Fizouaty
First
Maria olga
DOB
11/28/1958
County
Cobb
Street
3014 Stuarf Rich
City
Acworth
State
GA
Zip
30101-
Home
(404) 932-1435
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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