TAB-ROS-80

Code
TAB-ROS-80
Mercy ID
V-01499-01
Encounter Date
02/24/2004
Last
Tabora mxze
First
Rosa lidia
DOB
07/15/1980
County
Dekalb
Street
Shelter
City
Not given
State
GA
Zip
00000-0000
Home
(404) 297-5753
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
Adult, no formal education
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
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. Perez
Data Entry
K. Aleman