DIA-LIS-72

Code
DIA-LIS-72
Mercy ID
V-01886-01
Encounter Date
04/27/2005
Last
Diaz
First
Lisbeth
DOB
12/30/1972
County
Gwinnett
Street
4498 Buford Hwy #203
City
Norcross
State
GA
Zip
30071-
Home
(678) 558-2421
Cell
(678) 755-8251
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Single Family
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
Tambien con el apellido Chonay
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