IDE-JAN-80

Code
IDE-JAN-80
Mercy ID
V-01596-01
Encounter Date
05/17/2004
Last
Idelfonso
First
Janet
DOB
07/08/1980
County
Dekalb
Street
3536 Bufford Hwy Apt 8
City
Atlanta
State
GA
Zip
30329-
Home
(678) 768-5025
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Transitional
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
YES
Relative
YES
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