ESP-ROS-64

Code
ESP-ROS-64
Mercy ID
V-01331-01
Encounter Date
08/28/2003
Last
Espinal
First
Rosario
DOB
05/14/1964
County
Gwinnett
Street
2155 Hopkins Creek Dr.
City
Duluth
State
GA
Zip
30096-
Home
(770) 409-1530
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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