ORG-ROG-71

Code
ORG-ROG-71
Mercy ID
V-01428-02
Encounter Date
05/13/2008
Last
Organista
First
Rogelio
DOB
07/01/1971
County
Fulton
Street
201 Northwood Dr. Apt. D-2
City
Atlanta
State
GA
Zip
30342-
Home
(404) 252-5736
Cell
(770) 905-0831
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school
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. Manzo
Data Entry
J. Manzo