CAN-IRM-69

Code
CAN-IRM-69
Mercy ID
V-01375-01
Encounter Date
10/13/2003
Last
Canedo
First
Irma
DOB
07/14/1969
County
Gwinnett
Street
3160 Chandon Ln.
City
Lawrenceville
State
GA
Zip
30009-
Home
(404) 414-6346
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
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