CAR-LUI-65

Code
CAR-LUI-65
Mercy ID
V-01507-02
Encounter Date
03/16/2004
Last
Carillo
First
Luis
DOB
06/21/1965
County
Gwinnett
Street
4280 S. Lee St. HE10
City
Bufford
State
GA
Zip
30518-
Home
(678) 714-7457
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Preschool
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
R. Miranda
Data Entry
K. Aleman