CHA-CHR-69

Code
CHA-CHR-69
Mercy ID
V-01659-01
Encounter Date
07/23/2004
Last
Chavez
First
Christin
DOB
10/22/1969
County
Fulton
Street
1225 Wood Creek Trail
City
Roswell
State
GA
Zip
30076-
Home
(404) 454-8353
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma
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. Perez
Data Entry
K. Aleman