GIR-TER-74

Code
GIR-TER-74
Mercy ID
V-01736-01
Encounter Date
10/28/2004
Last
Girlando
First
Terra
DOB
10/16/1974
County
Other
Street
2206 Adsams St.
City
Hollywood St.
State
FL
Zip
33020-
Home
(954) 924-6337
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
Home Owner
YES

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