CUA-GLO-61

Code
CUA-GLO-61
Mercy ID
V-01334-01
Encounter Date
09/02/2003
Last
Cuartas
First
Gloria
DOB
10/28/1961
County
Cobb
Street
323 Himilton Trace
City
Marietta
State
GA
Zip
30068-
Home
(678) 560-2075
Cell
(770) 566-0454
Family Status
Adult coupie-no children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Some College
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