CLA-CRI-67

Code
CLA-CRI-67
Mercy ID
V-01964-01
Encounter Date
07/13/2005
Last
Clark
First
Cristina
DOB
06/21/1967
County
Gwinnett
Street
164 Ishlend Ct.
City
Lawrenceville
State
GA
Zip
30045-
Home
(770) 682-2928
Family Status
Single parent w/children
COB
Brazil
Gender
Female
Housing
Not Homeless
Education Level
High school graduate
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
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