PAL-ERN-73

Code
PAL-ERN-73
Mercy ID
V-01546-02
Encounter Date
10/23/2006
Last
Palma
First
Ernestino
DOB
09/03/1973
County
Cobb
Street
640 Whisper Trail # 302-B
City
Austell
State
GA
Zip
30168-
Home
(404) 838-1734
Cell
(678) 663-6663
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
High school graduate
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
F. Perez
Data Entry
J. Manzo