GON-EDE-39

Code
GON-EDE-39
Mercy ID
V-01785-01
Encounter Date
12/17/2004
Last
Gonzalez
First
Edelmira
DOB
05/20/1939
County
Fulton
Street
000 Not given
City
Not given
State
GA
Zip
00000-0000
Home
(770) 907-1916
Cell
(404) 371-0063
Family Status
Two parent family w/children
COB
Cuba
Gender
Female
Housing
Doubling Up
Education Level
Other
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