CHA-ALE-76

Code
CHA-ALE-76
Mercy ID
V-01551-01
Encounter Date
03/29/2004
Last
Chavez
First
Alejandra
DOB
03/26/1976
County
Cobb
Street
1915 Cardel Rd. T-10
City
Austell
State
GA
Zip
30168-
Home
(678) 945-7418
Cell
(770) 948-3707
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school
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
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