ROM-REB-86

Code
ROM-REB-86
Mercy ID
V-01570-01
Encounter Date
04/15/2004
Last
Romero
First
Rebeca
DOB
07/30/1986
County
Fulton
Street
1738 Wood Creek Trl.
City
Roswell
State
GA
Zip
30076-
Home
(678) 886-8546
Cell
(904) 491-6354
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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