CHA-DAR-61

Code
CHA-DAR-61
Mercy ID
V-01430-01
Encounter Date
01/06/2010
Last
Chazares
First
Daria
DOB
12/19/1961
County
Gwinnett
Street
918 Traymor Dr.
City
Norcross
State
GA
Zip
30093-
Home
(770) 931-1972
Family Status
Two parent family w/children
COB
Venezuela
Gender
Female
Housing
Single Family
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
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
J. Manzo