HEN-DIA-61

Code
HEN-DIA-61
Mercy ID
V-01925-01
Encounter Date
05/24/2005
Last
Henry
First
Diana
DOB
10/17/1961
County
Fulton
Street
3211 Hope St.
City
Hapeville
State
GA
Zip
30354-
Home
(770) 960-6116
Cell
(770) 324-8741
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Some College
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
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. Manzo
Data Entry
K. Aleman