PAV-IVI-74

Code
PAV-IVI-74
Mercy ID
V-01362-01
Encounter Date
10/06/2003
Last
Pavón
First
Ivis
DOB
12/29/1974
County
Gwinnett
Street
4853 Burns Rd.
City
Lilburn
State
GA
Zip
30043-
Home
(404) 542-9678
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
some high 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
Permiso
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