CLE-PAT-76

Code
CLE-PAT-76
Mercy ID
V-01175-01
Encounter Date
03/07/2003
Last
Clemente
First
Patricia
DOB
01/01/1976
County
Fulton
Street
5801 Kingsport Dr. 117
City
Atlanta
State
GA
Zip
30342-
Home
(404) 943-0992
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. Perez
Data Entry
K. Aleman