ROM-EUL-79

Code
ROM-EUL-79
Mercy ID
V-01876-01
Encounter Date
04/08/2005
Last
Romero
First
Eulalia
DOB
02/12/1979
County
Gwinnett
Street
702 Winn Hollow Tr. Apt 8
City
Norcross
State
GA
Zip
30071-
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
YES
Relative
YES
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