RAM-SAM-79

Code
RAM-SAM-79
Mercy ID
V-01606-01
Encounter Date
05/19/2004
Last
Ramirez
First
Samilpa
DOB
09/10/1979
County
Fulton
Street
1155 La Vista Rd. 310
City
Atlanta
State
GA
Zip
30324-
Home
(404) 320-7916
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high 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
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