LOP-ROS-62

Code
LOP-ROS-62
Mercy ID
V-01494-01
Encounter Date
02/17/2004
Last
Lopez
First
Rosemary
DOB
01/16/1962
County
Dekalb
Street
3126 Alston Dr.
City
Decatur
State
GA
Zip
30032-
Home
(999) 999-9999
Family Status
Single adult
COB
Mexico
Gender
Female
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
Her number is (678) 768-2844 but she does not wish to be contacted
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