VAL-VIV-80

Code
VAL-VIV-80
Mercy ID
V-01540-01
Encounter Date
03/23/2004
Last
Valencia
First
Viviana
DOB
01/04/1980
County
Clayton
Street
1175 Sallisbury Trl.
City
Riverdale
State
GA
Zip
30296-
Home
(000) 000-0000
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical
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
K. Aleman