GUZ-NAT-75

Code
GUZ-NAT-75
Mercy ID
V-01734-01
Encounter Date
10/13/2004
Last
Guzman
First
Natividad
DOB
12/14/1975
County
Cobb
Street
2640 Burrell Court
City
Kennesaw
State
GA
Zip
30144-
Home
(776) 562-4065
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
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. Manzo
Data Entry
K. Aleman