CHA-DAL-81

Code
CHA-DAL-81
Mercy ID
V-01848-01
Encounter Date
03/02/2005
Last
Chavez
First
Dalia
DOB
11/21/1981
County
Dekalb
Street
1750 Drearwood BB#10
City
Atlanta
State
GA
Zip
30329-
Home
(404) 327-6292
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
G. Landeros
Data Entry
K. Aleman