VAS-PAT-77

Code
VAS-PAT-77
Mercy ID
V-01258-01
Encounter Date
08/01/2003
Last
Vasquez
First
Patricia
DOB
02/23/1977
County
Clayton
Street
600 Valley Hill Rd. Apt B
City
Riverdale
State
GA
Zip
00000-0000
Home
(678) 358-1763
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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