CAR-EDI-70

Code
CAR-EDI-70
Mercy ID
V-01707-01
Encounter Date
09/20/2004
Last
Carillo
First
Edith
DOB
03/13/1970
County
Gwinnett
Street
3309 Dunleaf Arc Way NE
City
Norcross
State
GA
Zip
30093-
Home
(770) 717-9995
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Some College
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
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