FRA-EVE-63

Code
FRA-EVE-63
Mercy ID
V-00102-01
Encounter Date
02/23/2000
Last
Franco
First
Evelia
DOB
09/29/1963
County
Dekalb
Street
130 Surrey Circle Apt. 4
City
Chamblee
State
GA
Zip
30341-
Home
(000) 000-0000
Cell
(000) 000-0000
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
Grade school
Home Owner
YES

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