FLO-CAR-78

Code
FLO-CAR-78
Mercy ID
V-01717-01
Encounter Date
10/06/2004
Last
Flores
First
Carolina
DOB
05/27/1978
County
Cherokee
Street
120 Oak Forest Dr.
City
Canton
State
GA
Zip
30115-
Home
(678) 472-9431
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
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