MEN-LET-71

Code
MEN-LET-71
Mercy ID
V-01148-01
Encounter Date
03/07/2003
Last
Mendoza
First
Leticia
DOB
10/24/1971
County
Dekalb
Street
3711 Bufford Hwy Apt. 7
City
Atlanta
State
GA
Zip
30329-
Home
(678) 508-4269
Family Status
Two parent family w/children
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
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. Manzo
Data Entry
K. Aleman