CUA-CLA-65

Code
CUA-CLA-65
Mercy ID
V-01293-01
Encounter Date
07/23/2003
Last
Cuaspud
First
Clara
DOB
06/21/1965
County
Gwinnett
Street
3244 W. Summit Point Apt. C
City
Norcross
State
GA
Zip
30092-
Home
(770) 242-0364
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
High school graduate
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
YES
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