RIV-REN-79

Code
RIV-REN-79
Mercy ID
V-01217-01
Encounter Date
05/09/2003
Last
Rivera
First
Renata
DOB
11/11/1979
County
Dekalb
Street
3665 Chestnut Dr. Apt. F-4
City
Doraville
State
GA
Zip
30340-
Home
(770) 452-8558
Family Status
Single parent w/children
COB
Brazil
Gender
Female
Housing
Doubling Up
Education Level
Some College
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. Manzo
Data Entry
K. Aleman