MER-CLA-79

Code
MER-CLA-79
Mercy ID
V-01724-01
Encounter Date
10/14/2004
Last
Mera
First
Claudia
DOB
05/27/1979
County
Fulton
Street
6515 Lowes Dixie Ln
City
Union city
State
GA
Zip
30291-
Home
(770) 964-1559
Family Status
Adult coupie-no 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