ORE-BIB-72

Code
ORE-BIB-72
Mercy ID
V-01809-01
Encounter Date
01/14/2005
Last
Orellana
First
Bibian
DOB
09/23/1972
County
Gwinnett
Street
810 Kibe Cr.
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 381-8316
Cell
(404) 374-6646
Family Status
Single parent w/children
COB
Guatemala
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. Perez
Data Entry
K. Aleman